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CPT 99492: Psychiatric Collaborative Care Management, Initial 70 Minutes

CPT code 99492 designates the initial 70 minutes of psychiatric collaborative care management (CoCM) provided in the first calendar month for patients receiving behavioral health treatment with regular psychiatric interspecialty consultation. This code captures structured, team-based care delivered in collaboration with a patient’s treating or billing primary care provider and is important for documenting time-intensive coordination that supports integrated behavioral health services in ambulatory settings. Nationally, use of CoCM codes reflects growing emphasis on integrated care models that link primary care and behavioral health specialists to expand access and improve outcomes.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical service and billing context, common coding relationships, and payer coverage considerations. The publication summarizes benchmark measures and utilization patterns where available, summarizes relevant policy and reimbursement updates affecting collaborative care codes, and provides clinical context that clarifies when 99492 applies versus other CoCM or psychiatric codes. Data not available in the input is noted where applicable.

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Billing Code Overview

CPT code 99492 describes psychiatric collaborative care management (CoCM) provided for a patient receiving behavioral health treatment with regular psychiatric interspecialty consultation. The code is reported for the initial 70 minutes of CoCM furnished in the first calendar month of treatment.

Service type: Collaborative psychiatric care management, delivered as part of an integrated behavioral health program working in collaboration and in conjunction with a patient’s treating or billing primary care provider.

Typical site of service: Primary care offices, outpatient behavioral health clinics, or other ambulatory settings where primary care and behavioral health services are coordinated.

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CPT 99492: Psychiatric Collaborative Care Management, Initial 70 Minutes

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Billing Code Overview

Typical site of service: Primary care offices, outpatient behavioral health clinics, or other ambulatory settings where primary care and behavioral health services are coordinated.

Clinical & Coding Specifications

Clinical Context

A typical patient is a 45-year-old established primary care patient with persistent depressive symptoms and impaired function despite initial office-based management. The primary care provider refers for psychiatric collaborative care management (CoCM). The psychiatric consultant (a psychiatrist) and a behavioral health care manager collaborate with the treating primary care provider to deliver CoCM. During the first calendar month of enrollment, the psychiatrist provides the initial psychiatric CoCM service consisting of at least 70 minutes of work in the month, including review of the patient’s history, diagnostic formulation, treatment recommendations, participation in caseload review, and direct contact with the patient or primary care team as needed. Typical workflow: the primary care clinician identifies the need for CoCM and enrolls the patient; the behavioral health care manager performs measurement-based care, care coordination, and brief psychotherapy; the psychiatric consultant performs initial case review, documents treatment plan and recommendations in the medical record, communicates with the primary care provider, and may have direct patient contact. Usual site of service is the outpatient primary care clinic or community behavioral health setting integrated with primary care; services are billed by the consulting psychiatric provider in conjunction with the patient’s treating primary care provider.

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service	Use when the primary care E/M is distinct from CoCM activities and must be reported separately on the same date.
`52`	Reduced services	Use when CoCM services are partially furnished and the reporting provider reduces the service scope.
`53`	Discontinued procedure	Use if CoCM enrollment is initiated but terminated due to patient factors before minimum time thresholds are met.
`62`	Two surgeons or co-surgeons (interpreted here as shared specialty care)	Rarely applicable; use only if two qualified psychiatric consultants share responsibility per payer rules.
`78`	Unplanned return to the operating room (not typical)	Not generally applicable; included only when applicable per payer instruction for unrelated procedural returns.
`80`	Assistant at surgery (not typical)	Not applicable to CoCM; do not use routinely.
`95`	Synchronous telemedicine service rendered via real-time interactive audio and video	Use when CoCM psychiatric consultant services are delivered live via telehealth platforms.
`GT`	Via interactive audio and video telecommunication systems	Use for synchronous telehealth delivery when payer recognizes `GT`.
`QK`	Medical direction of two or more qualified health care professionals by a physician (Old modifier for CRNA)	Not routinely applicable; include only if payer rules require this modifier for supervision arrangements.
`QX`	CRNA service: service performed by a CRNA with qualified supervision (legacy)	Not applicable to CoCM; do not use routinely.

Taxonomy Code	Specialty	Notes
2084P0800X	Psychiatry & Neurology	Psychiatrist who performs psychiatric consultation for CoCM.
367500000X	Behavioral Health & Social Service Providers	Behavioral health care manager (e.g., licensed clinical social worker) involved in care management.
207Q00000X	Family Medicine	Primary care treating provider coordinating with CoCM team.
207R00000X	Internal Medicine	Primary care internist participating in the CoCM model.
363L00000X	Nurse Practitioner	Psychiatric nurse practitioner providing consultation in collaborative care.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`F32.1`	Major depressive disorder, single episode, moderate	Common primary diagnosis for patients enrolled in CoCM for depressive symptoms requiring psychiatric consultation.
`F33.1`	Major depressive disorder, recurrent, moderate	Recurrent depression often managed in primary care with psychiatric collaborative support.
`F41.1`	Generalized anxiety disorder	Anxiety disorders frequently co-occur with depression and are managed within CoCM.
`F43.21`	Adjustment disorder with depressed mood	Short-term depressive symptoms treated with collaborative care and behavioral health management.
`F32.9`	Major depressive disorder, single episode, unspecified	Used when depression is present but severity unspecified at enrollment in CoCM.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99492`	Psychiatric collaborative care management, initial 70 minutes in the first calendar month	Primary code for the initial month of CoCM; documents the psychiatrist’s initial 70 minutes of clinical care management and consultation.
`99493`	Psychiatric collaborative care management, initial 60 minutes in a subsequent month	Used for subsequent months when at least 60 minutes of CoCM are provided by the psychiatric consultant.
`99494`	Psychiatric collaborative care management, each additional 30 minutes in a calendar month (add-on)	Reported in addition to `99492` or `99493` when additional psychiatrist time is provided in the month.
`90791`	Psychiatric diagnostic evaluation (no medical services)	May be performed if an initial face-to-face psychiatric diagnostic evaluation is needed outside the CoCM framework.
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, low to moderate complexity	Typical primary care E/M visit that may occur on the same day; report with modifier `25` if separately identifiable from CoCM activities.

CPT 99493: Psychiatric Collaborative Care Management, First 60 Minutes

CPT-99494-PSYCHIATRIC-COLLABORATIVE-CARE-MANAGEMENT-ADDITIONAL-30-MIN

CPT 99494: Psychiatric Collaborative Care Management, Additional 30 Minutes

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

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Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service	Use when the primary care E/M is distinct from CoCM activities and must be reported separately on the same date.
`52`	Reduced services	Use when CoCM services are partially furnished and the reporting provider reduces the service scope.
`53`	Discontinued procedure	Use if CoCM enrollment is initiated but terminated due to patient factors before minimum time thresholds are met.
`62`	Two surgeons or co-surgeons (interpreted here as shared specialty care)	Rarely applicable; use only if two qualified psychiatric consultants share responsibility per payer rules.
`78`	Unplanned return to the operating room (not typical)	Not generally applicable; included only when applicable per payer instruction for unrelated procedural returns.
`80`	Assistant at surgery (not typical)	Not applicable to CoCM; do not use routinely.
`95`	Synchronous telemedicine service rendered via real-time interactive audio and video	Use when CoCM psychiatric consultant services are delivered live via telehealth platforms.
`GT`	Via interactive audio and video telecommunication systems	Use for synchronous telehealth delivery when payer recognizes `GT`.
`QK`	Medical direction of two or more qualified health care professionals by a physician (Old modifier for CRNA)	Not routinely applicable; include only if payer rules require this modifier for supervision arrangements.
`QX`	CRNA service: service performed by a CRNA with qualified supervision (legacy)	Not applicable to CoCM; do not use routinely.

Taxonomy Code	Specialty	Notes
2084P0800X	Psychiatry & Neurology	Psychiatrist who performs psychiatric consultation for CoCM.
367500000X	Behavioral Health & Social Service Providers	Behavioral health care manager (e.g., licensed clinical social worker) involved in care management.
207Q00000X	Family Medicine	Primary care treating provider coordinating with CoCM team.
207R00000X	Internal Medicine	Primary care internist participating in the CoCM model.
363L00000X	Nurse Practitioner	Psychiatric nurse practitioner providing consultation in collaborative care.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`F32.1`	Major depressive disorder, single episode, moderate	Common primary diagnosis for patients enrolled in CoCM for depressive symptoms requiring psychiatric consultation.
`F33.1`	Major depressive disorder, recurrent, moderate	Recurrent depression often managed in primary care with psychiatric collaborative support.
`F41.1`	Generalized anxiety disorder	Anxiety disorders frequently co-occur with depression and are managed within CoCM.
`F43.21`	Adjustment disorder with depressed mood	Short-term depressive symptoms treated with collaborative care and behavioral health management.
`F32.9`	Major depressive disorder, single episode, unspecified	Used when depression is present but severity unspecified at enrollment in CoCM.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99492`	Psychiatric collaborative care management, initial 70 minutes in the first calendar month	Primary code for the initial month of CoCM; documents the psychiatrist’s initial 70 minutes of clinical care management and consultation.
`99493`	Psychiatric collaborative care management, initial 60 minutes in a subsequent month	Used for subsequent months when at least 60 minutes of CoCM are provided by the psychiatric consultant.
`99494`	Psychiatric collaborative care management, each additional 30 minutes in a calendar month (add-on)	Reported in addition to `99492` or `99493` when additional psychiatrist time is provided in the month.
`90791`	Psychiatric diagnostic evaluation (no medical services)	May be performed if an initial face-to-face psychiatric diagnostic evaluation is needed outside the CoCM framework.
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, low to moderate complexity	Typical primary care E/M visit that may occur on the same day; report with modifier `25` if separately identifiable from CoCM activities.

CPT 99493: Psychiatric Collaborative Care Management, First 60 Minutes

CPT-99494-PSYCHIATRIC-COLLABORATIVE-CARE-MANAGEMENT-ADDITIONAL-30-MIN

CPT 99494: Psychiatric Collaborative Care Management, Additional 30 Minutes

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

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CPT 99492: Psychiatric Collaborative Care Management, Initial 70 Minutes

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Billing Code Overview

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CPT 99492: Psychiatric Collaborative Care Management, Initial 70 Minutes

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References