{"id":14382,"date":"2021-10-07T14:28:23","date_gmt":"2021-10-07T14:28:23","guid":{"rendered":"https:\/\/www.medicalbillersandcoders.com\/blog\/?p=14382"},"modified":"2025-05-19T13:16:14","modified_gmt":"2025-05-19T13:16:14","slug":"billing-codes-for-psychiatric-collaborative-care-management","status":"publish","type":"post","link":"https:\/\/www.medicalbillersandcoders.com\/blog\/billing-codes-for-psychiatric-collaborative-care-management\/","title":{"rendered":"Billing Codes for Psychiatric Collaborative Care Management"},"content":{"rendered":"<div class=\"react-scroll-to-bottom--css-rttqt-1n7m0yu\">\r\n<div class=\"flex flex-col text-sm pb-9\">\r\n<div class=\"w-full text-token-text-primary sm:AIPRM__conversation__response\" data-testid=\"conversation-turn-107\">\r\n<div class=\"px-4 py-2 justify-center text-base md:gap-6 m-auto\">\r\n<div class=\"flex flex-1 text-base mx-auto gap-3 md:px-5 lg:px-1 xl:px-5 md:max-w-3xl lg:max-w-[40rem] xl:max-w-[48rem] group final-completion\">\r\n<div class=\"relative flex w-full flex-col agent-turn\">\r\n<div class=\"flex-col gap-1 md:gap-3\">\r\n<div class=\"flex flex-grow flex-col max-w-full\">\r\n<div class=\"min-h-[20px] text-message flex flex-col items-start gap-3 whitespace-pre-wrap break-words [.text-message+&amp;]:mt-5 overflow-x-auto\" data-message-author-role=\"assistant\" data-message-id=\"2ab4a548-f443-4cce-bb63-bd1f2dca29c3\">\r\n<div class=\"markdown prose w-full break-words dark:prose-invert light AIPRM__conversation__response\">\r\n<p>Understanding billing codes for psychiatric collaborative care management is crucial for healthcare providers offering mental health services. These codes help ensure proper reimbursement for the collaborative care provided to patients. By accurately using these codes, healthcare providers can effectively communicate the services rendered and receive appropriate compensation for their valuable contributions to mental health care.<\/p>\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<h2><span style=\"font-weight: 400;\">What is Collaborative Care Management (CoCM)?\u00a0<\/span><\/h2>\r\n<p><span style=\"font-weight: 400;\">Psychiatric Collaborative Care Management (CoCM) is typically provided by a primary care team consisting of a primary care physician and a care manager who collaborate with a psychiatric consultant, such as a psychiatrist. The primary care team directs care and includes structured care management with regular assessments of clinical status using validated tools and treatment modification as appropriate. The psychiatric consultant provides regular consultations with the primary care team to review the clinical status and care of patients and to make recommendations.<\/span><\/p>\r\n<h2><span style=\"font-weight: 400;\">Billing Codes for Psychiatric Collaborative Care Management<\/span><\/h2>\r\n<h3><span style=\"font-weight: 400;\">CPT Code 99492<\/span><\/h3>\r\n<p><span style=\"font-weight: 400;\">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:<\/span><\/p>\r\n<ul>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Outreach to and engagement in the treatment of a patient directed by the treating physician or other qualified health care professional;\u00a0<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Initial assessment of the patient, including administration of validated rating scales, with the development of an individualized treatment plan;\u00a0<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Review by the psychiatric consultant with modifications of the plan if recommended;<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Entering patients in a registry and tracking patient follow-up and progress using the registry, with appropriate documentation, participation in weekly caseload consultation with the psychiatric consultant, and<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Provision of brief interventions using evidence-based techniques such as behavioral activation, motivational interviewing, and other focused treatment strategies.<\/span><\/li>\r\n<\/ul>\r\n<h3><span style=\"font-weight: 400;\">CPT Code 99493<\/span><\/h3>\r\n<p><span style=\"font-weight: 400;\">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:<\/span><\/p>\r\n<ul>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Tracking patient follow-up and progress using the registry, with appropriate documentation;<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Participation in weekly caseload consultation with the psychiatric consultant;\u00a0<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ongoing collaboration with and coordination of the patient\u2019s mental health care with the treating physician or other qualified health care professional and any other treating mental health providers;\u00a0<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Additional review of progress and recommendations for changes in treatment, as indicated, including medications, based on recommendations provided by the psychiatric consultant;<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Provision of brief interventions using evidence-based techniques such as behavioral activation, motivational interviewing, and other focused treatment strategies;\u00a0<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Patient outcomes are monitored using validated rating scales, and relapse prevention plans are developed with patients as they achieve remission of symptoms and\/or other treatment goals and are prepared for discharge from active treatment.<\/span><\/li>\r\n<\/ul>\r\n<h3><span style=\"font-weight: 400;\">CPT Code 99494<\/span><\/h3>\r\n<p><span style=\"font-weight: 400;\">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). (Use 99494 in conjunction with 99492 and 99493).<\/span><\/p>\r\n<h3><span style=\"font-weight: 400;\">Calculation of Time<\/span><\/h3>\r\n<p><span style=\"font-weight: 400;\">The billing of these codes is based on how much time the behavioral health care manager spends doing clinical work (face-to-face and non-face-to-face) with the patient. The CPT \u201cTime Rule\u201d applies to these services, which means that the service can be billed when the midpoint of the stated time has passed. Payer policies vary, and services in an FQHC and RHC differ.<\/span><\/p>\r\n<h3><span style=\"font-weight: 400;\">CPT Code 99484<\/span><\/h3>\r\n<p><span style=\"font-weight: 400;\">CMS created a code to describe general care management services for patients with behavioral health conditions, incorporating some but not all of the principles associated with collaborative care. The service can be billed once you reach at least 20 minutes of clinical staff time. 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:<\/span><\/p>\r\n<ul>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Initial assessment or follow-up monitoring, including the use of applicable validated rating scales;\u00a0<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Behavioral health care planning concerning behavioral\/psychiatric health problems, including revision for patients who are not progressing or whose status changes;\u00a0<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Facilitating and coordinating treatment such as psychotherapy, pharmacotherapy, counseling, and\/or psychiatric consultation; and\u00a0<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Continuity of care with a designated member of the care team.<\/span><\/li>\r\n<\/ul>\r\n<h2><span style=\"font-weight: 400;\">Billing Services in FQHC and RHC<\/span><\/h2>\r\n<p><span style=\"font-weight: 400;\">CMS has incorporated the payment for FQHCs and RHCs into two HCPCS codes. When billing for the general care management service and care management for behavioral health conditions &#8211; use G0511, and when billing for Collaborative care services, use G0512. FQHCs and RHCs do not recognize the CPT time rule or add-on code for additional time. You must provide the full 70 (initial) or 60 (subsequent) minutes before billing for the service, and sites are not paid for additional time. You must review the specific requirements associated with billing in these settings.\u00a0<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">We shared billing codes for Psychiatric Collaborative Care Management, but that\u2019s not enough. You might face many other billing questions while <a href=\"https:\/\/www.medicalbillersandcoders.com\/speciality\/behavioral-health-medical-billing-services.html\">billing for Psychiatric Collaborative Care Management<\/a>, such as: Who bills for these services? Who can play the behavioral health care manager role? What are his qualifications? What are the qualifications for a psychiatric consultant? How do I get paid as a psychiatric consultant? Who can provide BHI services?\u00a0<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">There is a more straightforward solution; <a href=\"https:\/\/www.medicalbillersandcoders.com\/contact-us.aspx\">contact us for your billing and coding requirements<\/a>, and our <strong>Psychiatric Billing<\/strong> experts will handle it all for you. Medical Billers and Coders (MBC) can streamline your billing and coding functions and can improve insurance reimbursements. Our expert <a href=\"https:\/\/www.medicalbillersandcoders.com\/\">medical billers and coders can help streamline your billing and coding processes<\/a>, such as eligibility and benefits verification, prior authorizations, charge entry, claim submissions, payment posting, denial handling, accounts receivable management, medical coding, and provider credentialing. To learn more about our commitment to excellence and performance for medical practices and healthcare providers, contact us at <a href=\"mailto:info@medicalbillersandcoders.com\">info@medicalbillersandcoders.com<\/a>\/ <a href=\"tel:888-357-3226\"><strong>888-357-3226<\/strong><\/a>.<\/span><\/p>\r\n<h2>FAQs<\/h2>\r\n<div class=\"min-h-8 text-message flex w-full flex-col items-end gap-2 whitespace-normal break-words [.text-message+&amp;]:mt-5\" dir=\"auto\" data-message-author-role=\"assistant\" data-message-id=\"bd2e8ad7-e8ac-499b-9dbf-aca1418f7d30\">\r\n<div class=\"flex w-full flex-col gap-1 empty:hidden first:pt-[3px]\">\r\n<div class=\"markdown prose w-full break-words dark:prose-invert light\">\u00a0<\/div>\r\n<\/div>\r\n<\/div>\r\n\r\n<div class=\"schema-faq wp-block-yoast-faq-block\">\r\n<div id=\"faq-question-1747652489310\" class=\"schema-faq-section\"><strong class=\"schema-faq-question\"><strong>Q: What is Psychiatric Collaborative Care Management (CoCM)?<\/strong><\/strong>\r\n<p class=\"schema-faq-answer\">A: CoCM is a structured care model where a primary care physician and a care manager collaborate with a psychiatric consultant, such as a psychiatrist, to manage and monitor a patient\u2019s mental health treatment.<\/p>\r\n<\/div>\r\n<div id=\"faq-question-1747652556812\" class=\"schema-faq-section\"><strong class=\"schema-faq-question\"><strong>Q: What is CPT Code 99492 used for?<\/strong><\/strong>\r\n<p class=\"schema-faq-answer\">A: CPT Code 99492 is used for billing the initial psychiatric collaborative care management during the first 70 minutes in the first calendar month, including tasks like patient assessment, treatment planning, and regular consultations with a psychiatric consultant.<\/p>\r\n<\/div>\r\n<div id=\"faq-question-1747652617141\" class=\"schema-faq-section\"><strong class=\"schema-faq-question\"><strong>Q: What is CPT Code 99494?<\/strong><\/strong>\r\n<p class=\"schema-faq-answer\">A: CPT Code 99494 is used for additional 30-minute increments of psychiatric collaborative care management in a calendar month, billed alongside codes 99492 or 99493.<\/p>\r\n<\/div>\r\n<div id=\"faq-question-1747652585579\" class=\"schema-faq-section\"><strong class=\"schema-faq-question\"><strong>Q: When should CPT Code 99493 be used?<\/strong><\/strong>\r\n<p class=\"schema-faq-answer\">A: CPT Code 99493 is for billing subsequent months of psychiatric collaborative care management, covering 60 minutes of follow-up patient care, progress monitoring, and treatment modification.<\/p>\r\n<\/div>\r\n<div id=\"faq-question-1747652644499\" class=\"schema-faq-section\"><strong class=\"schema-faq-question\"><strong>Q: What is the difference between CPT Codes 99492, 99493, and 99494?<\/strong><\/strong>\r\n<p class=\"schema-faq-answer\">A: CPT Code 99492 is for the initial month\u2019s care management, 99493 is for follow-up care in subsequent months, and 99494 is for additional 30-minute increments of care management.<br \/>CPT\u00ae is a trademark of the <a href=\"https:\/\/www.ama-assn.org\/\">American Medical Association (AMA)<\/a>.<\/p>\r\n<\/div>\r\n<\/div>\r\n","protected":false},"excerpt":{"rendered":"<p>Understanding billing codes for psychiatric collaborative care management is crucial for healthcare providers offering mental health services. These codes help ensure proper reimbursement for the collaborative care provided to patients. By accurately using these codes, healthcare providers can effectively communicate the services rendered and receive appropriate compensation for their valuable contributions to mental health care. [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":23250,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3545],"tags":[3678,4701,2861,3677,3676,2864,4078,4700,2867],"class_list":["post-14382","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-behavioral-health-billing","tag-behavioral-health-care-manager","tag-billing-codes-for-psychiatric","tag-billing-codes-for-psychiatric-collaborative-care-management","tag-billing-for-psychiatric-collaborative-care-management","tag-billing-services-in-fqhc-and-rhc","tag-collaborative-care-management","tag-medical-billers-and-coders-mbc","tag-psychiatric-billing","tag-psychiatric-collaborative-care-management"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.9 (Yoast SEO v27.9) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Billing Codes for 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