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See a sample rate comparisonCPT 99494 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
1st Sbsq Psyc Collab Care, Initial Or Subsequent Psychiatric Collaborative Care Management Each Additional 30 Minutes In A Calendar Month Of Behavioral Health Care Manager Activities In Consultation With A Psychiatric Consultant And Directed By The Treating Physician Or Other Qualified Health Care Professional List Separately In Addition To Code For Primary Procedure
| Key Fact | Detail |
|---|---|
| Service Type | Evaluation and Management Psychiatric Collaborative Care Management Services |
| Common Place of Service | 11 - Office 19 - Off Campus Outpatient Hospital |
| Common Modifiers | 25 - Significant, separately identifiable E/M service same day 95 - Telemedicine - audio and video |
| Complexity Level | Low |
| Medicare Fee Schedule | $61.46 national non-facility rate (2026) · View Medicare rates for 99494 |
| Medicaid Fee Schedule | $47.855 median of the 8 states in the free preview · View Medicaid rates for 99494 |
National average reimbursement for CPT 99494 by major payers:
$69.21
$80.04
$66.71
$103.27
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CPT 99494
5 of 25 sample ratesHigher to lower in this preview
Rafic Berbarie
$157.91Published rateChunyen Liu
United Hospital District Inc
$101.94Published rateJackson Reynolds
$75.55Published rateMartin Mboe
Global Wound Care Medical Group
$47.90Published rateSuzanne Miller
Access Telecare PLLC
$34.65Published rate
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See a sample payer proposalCPT 99494 vs. Other Psychiatric Collaborative Care Management Services Codes
The CPT 99494 code is part of the Evaluation and Management services used for Psychiatric Collaborative Care Management Services. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 99494 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 99484-CPT | Low | Care Mgmt Svc Bhvl Hlth Cond, Care Management Services For Behavioral Health Conditions At Least 20 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional Per Calendar Month With The Following Required Elements Initial Assessment Or Follow Up Monitoring Including The Use Of Applicable Validated Rating Scales Behavioral Health Care Planning In Relation To Behavioral Psychiatric Health Problems Including Revision For Patients Who Are Not Progressing Or Whose Status Changes Facilitating And Coordinating Treatment Such As Psychotherapy Pharmacotherapy Counseling And Or Psychiatric Consultation And Continuity Of Care With A Designated Member Of The Care Team |
| 99492-CPT | Low | 1st Psyc Collab Care Mgmt, Initial Psychiatric Collaborative Care Management First 70 Minutes In The First Calendar Month Of Behavioral Health Care Manager Activities In Consultation With A Psychiatric Consultant And Directed By The Treating Physician Or Other Qualified Health Care Professional With The Following Required Elements Outreach To And Engagement In Treatment Of A Patient Directed By The Treating Physician Or Other Qualified Health Care Professional Initial Assessment Of The Patient Including Administration Of Validated Rating Scales With The Development Of An Individualized Treatment Plan Review By The Psychiatric Consultant With Modifications Of The Plan If Recommended Entering Patient In A Registry And Tracking Patient Follow Up And Progress Using The Registry With Appropriate Documentation And Participation In Weekly Caseload Consultation With The Psychiatric Consultant And Provision Of Brief Interventions Using Evidence Based Techniques Such As Behavioral Activation Motivational Interviewing And Other Focused Treatment Strategies |
| 99493-CPT | Low | Sbsq Psyc Collab Care Mgmt, Subsequent Psychiatric Collaborative Care Management First 60 Minutes In A Subsequent Month Of Behavioral Health Care Manager Activities In Consultation With A Psychiatric Consultant And Directed By The Treating Physician Or Other Qualified Health Care Professional With The Following Required Elements Tracking Patient Follow Up And Progress Using The Registry With Appropriate Documentation Participation In Weekly Caseload Consultation With The Psychiatric Consultant Ongoing Collaboration With And Coordination Of The Patient S Mental Health Care With The Treating Physician Or Other Qualified Health Care Professional And Any Other Treating Mental Health Providers Additional Review Of Progress And Recommendations For Changes In Treatment As Indicated Including Medications Based On Recommendations Provided By The Psychiatric Consultant Provision Of Brief Interventions Using Evidence Based Techniques Such As Behavioral Activation Motivational Interviewing And Other Focused Treatment Strategies Monitoring Of Patient Outcomes Using Validated Rating Scales And Relapse Prevention Planning With Patients As They Achieve Remission Of Symptoms And Or Other Treatment Goals And Are Prepared For Discharge From Active Treatment |
| 99494-CPT | Low | 1st Sbsq Psyc Collab Care, Initial Or Subsequent Psychiatric Collaborative Care Management Each Additional 30 Minutes In A Calendar Month Of Behavioral Health Care Manager Activities In Consultation With A Psychiatric Consultant And Directed By The Treating Physician Or Other Qualified Health Care Professional List Separately In Addition To Code For Primary Procedure |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99494. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99494 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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