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    v1.0.30
    OpenPayerBilling CodesPsychiatric Collaborative Care Management ServicesCPT cpt-99492-psychiatric-collaborative-care-management-initial-70-min
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    CPT 99492: Psychiatric Collaborative Care Management, Initial 70 Minutes

    Medicare pays $166 on average nationally for this procedure.

    CPT code 99492 describes psychiatric collaborative care management (CoCM) provided by a psychiatric clinician who delivers behavioral health care and provides regular interspecialty psychiatric consultation in collaboration with a patient’s treating primary care provider; it is reported for the initial 70 minutes of CoCM in the first calendar month, typically delivered as care management/consultation services in an outpatient primary care or behavioral health clinic setting where the primary care provider manages the patient’s overall care.

    For related coverage guidance, see recent payer policy updates: Pediatric Neurodevelopmental and Autism Spectrum Disorder (ASD) Screening Corporate Medical Policy, Inhaled Nitric Oxide Therapy (for New Mexico Only), Inhaled Nitric Oxide Therapy (for North Carolina Only).

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    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.

    Related CPT Codes

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

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    25CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    95Modifier 95 indicates that a service was provided via synchronous, real‑time audio‑video telehealth rather than in‑person. Per CMS, AAPC and professional associations, append modifier 95 to claim…- Use modifier 95 to indicate a service was furnished via synchronous, real‑time audiovisual telehealth (a live audio‑video conference between patient and provider) rather than in‑person. - Pair…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    2084P0800X
    367500000X
    207Q00000X
    207R00000X
    363L00000X
    2085N0904X
    3336M0003X
    247000000X

    Related ICD-10-CM Codes

    27 rows

    ICD-10-CM CodeDescription
    F06.4Anxiety disorder due to known physiological condition
    F06.8Other specified mental disorders due to known physiological condition
    F10.20Alcohol dependence, uncomplicated
    F11.20Opioid dependence, uncomplicated
    F12.20Cannabis dependence, uncomplicated
    F19.20Other psychoactive substance dependence, uncomplicated
    F32.1Major depressive disorder, single episode, moderate
    F32.9Major depressive disorder, single episode, unspecified
    F33.1Major depressive disorder, recurrent, moderate
    F33.9Major depressive disorder, recurrent, unspecified

    Showing 1–10 of 27

    Related Payer Policy Updates

    Specialty: Pediatrics/Neonatology1 / 2

    10 rows

    PolicyPayerEffective Date
    Pediatric Neurodevelopmental and Autism Spectrum Disorder (ASD) Screening Corporate Medical Policybcbsvermont2026-12-01
    Inhaled Nitric Oxide Therapy (for New Mexico Only)UnitedHealthcare2026-10-01
    Inhaled Nitric Oxide Therapy (for North Carolina Only)UnitedHealthcare2026-10-01
    Inhaled Nitric Oxide Therapy (for Pennsylvania Only)UnitedHealthcare2026-10-01
    Inhaled Nitric Oxide Therapy (for Kentucky Only)UnitedHealthcare2026-10-01
    Clinical Policy: NICU Apnea Bradycardia GuidelinesAmbetter Nevada2026-10-01
    DRG Newborn Inpatient Stays - FacilityBlue Cross Blue Shield - Maine2026-10-01
    Pediatric Preventive ScreeningOscar Health2026-10-01
    Infant Nutritional FormulaCigna2026-09-15
    Pediatric Preventive ScreeningBlue Cross Blue Shield - New Mexico2026-09-04

    Related Codes

    CPT-99493-PSYCHIATRIC-COLLABORATIVE-CARE-MANAGEMENT-60-MINUTES

    CPT 99493: Psychiatric Collaborative Care Management, 60 Minutes

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

    CPT 99494: Psychiatric Collaborative Care Management, Additional 30 Minutes

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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