CPT code 99484: Behavioral health management, general integration service2026 Medicare rate & RVUs in Washington, DC area

Monthly behavioral health integration for a patient with a behavioral or psychiatric condition when clinical staff provide at least 20 minutes of directed care management.

CMS RVU26DEffective Oct 1, 2026One payment locality438.7K Medicare services in 2024

In Washington, DC area, Medicare pays $63.69 for 99484 in the office and $41.66 when it’s performed in a hospital or facility.

$63.69Office (non-facility)
$41.66Hospital or facility
+10.9%vs the national office rate ($57.45)

Check a contract rate as a % of Medicare · 99484 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 99484 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 99484 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 99484 covers

99484 covers ongoing integration of behavioral health care into a patient’s medical care. A physician or other qualified health professional directs the service, while clinical staff may perform the care-management work. Typical situations include supporting a primary care patient being treated for depression or anxiety through monitoring, care planning, and coordination with behavioral health services. The work can take place in an office-based practice or another setting where the patient’s medical care is managed.

Report the code once for a calendar month in which the required clinical-staff time is met; it is not reported per call or contact. Documentation should identify the behavioral or psychiatric condition, assessment or monitoring, care-planning and coordination work, total time, and clinician direction. Assessment, care planning, treatment coordination, and continuity activities are parts of this monthly service, rather than separate units of 99484. CMS assigns the code physician work and practice-expense values, with different practice-expense inputs for office and facility settings.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Washington, DC area compares for 99484

Across 109 of 109 payment localities, the office rate for 99484 runs from $53.04 in Arkansas to $73.67 in Alaska. Washington, DC area pays $63.69. The RVUs are the same everywhere; the geographic indexes change the dollars.

99484 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$63.69
  2. Los Angeles, CA · California$62.51−$1.18
  3. Miami, FL · Florida$61.51−$2.18
  4. Chicago, IL · Illinois$60.38−$3.31
  5. Manhattan, NY · New York$64.56+$0.87
  6. Alaska · Alaska$73.67+$9.98
  7. Alabama · Alabama$53.53−$10.16

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

99484 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$53.04$36.97
ArizonaArizona$56.41$38.28
Bakersfield, CACalifornia$59.60$39.10
Chico, CACalifornia$59.39$38.89
El Centro, CACalifornia$59.40$38.90
Fresno, CACalifornia$59.39$38.89
Hanford, CACalifornia$59.39$38.89
Madera, CACalifornia$59.39$38.89

99484 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$53.04

$73.67

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
99484 office rate range by state
State / territoryOffice rate rangeLocalities
AK$73.671
AL$53.531
AR$53.041
AZ$56.411
CA$59.39–$70.7129
CO$58.941
CT$60.371
DC$63.691
DE$57.111
FL$57.38–$61.513
GA$55.20–$58.342
GU$59.951
HI$59.951
IA$54.171
ID$54.441
IL$56.46–$60.384
IN$54.641
KS$54.111
KY$54.571
LA$54.56–$56.282
MA$58.83–$63.232
MD$57.89–$63.693
ME$54.74–$56.492
MI$55.59–$57.972
MN$56.751
MO$54.03–$56.283
MS$53.541
MT$57.451
NC$55.091
ND$56.261
NE$54.331
NH$58.201
NJ$61.13–$63.442
NM$55.831
NV$57.141
NY$55.64–$65.765
OH$55.341
OK$54.391
OR$56.76–$60.142
PA$55.34–$59.402
PR$57.691
RI$58.631
SC$55.301
SD$56.121
TN$54.301
TX$55.11–$58.708
UT$55.781
VA$56.45–$63.692
VI$57.691
VT$56.221
WA$58.67–$64.172
WI$55.041
WV$55.121
WY$56.931

See 99484 in every payment locality

How the 99484 rate is calculated

Each of 99484’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 99484

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.93

0.93 RVUs× 1.000 GPCI

Practice expense0.73

0.73 RVUs× 1.000 GPCI

Malpractice0.06

0.06 RVUs× 1.000 GPCI

Adjusted RVUs

1.7200

Conversion factor

$33.4009

Medicare rate

$57.45

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

13,149

Code
99484
Physician work
0.93
Practice expense
0.73
Malpractice
0.06

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 99484 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work0.93× 1.0540.9802
Practice expense0.73× 1.1780.8599
Malpractice0.06× 1.1130.0668
Total RVUs1.9069
Conversion factor× 33.4009

Office rate, Washington, DC area$63.69

Office: (0.93 × 1.054 + 0.73 × 1.178 + 0.06 × 1.113) × $33.4009 = $63.69

Facility: (0.93 × 1.054 + 0.17 × 1.178 + 0.06 × 1.113) × $33.4009 = $41.66

Open 99484 in the RVU calculator

Payment rules and modifiers for 99484

99484 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

Place of service · 99484

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

$57.45

Non-facility (office)
$57.45
Facility
$38.75

Higher because the practice carries its own overhead.

How 99484 has changed in Washington, DC area

99484 · Office / nonfacility

$63.69

Effective 2026-10-01

The base rate is $4.56 higher than on 2025-10-01, moving from $59.13 to $63.69 (7.7%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $59.13changed to$63.69

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.66 changed to 0.73
    • Malpractice RVU 0.05 changed to 0.06
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $61.24changed to$59.13

    • Conversion factor 33.2875 changed to 32.3465
    • Malpractice RVU 0.06 changed to 0.05

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $60.24changed to$61.24

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $49.00changed to$60.24

    • Conversion factor 33.8872 changed to 32.7442
    • Work RVU 0.61 changed to 0.93
    • Practice expense RVU 0.62 changed to 0.66
    • Malpractice RVU 0.04 changed to 0.06
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168
  5. January 1, 2023

    RVU23A

    $51.42changed to$49.00

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.64 changed to 0.62
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $54.00changed to$51.42

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.69 changed to 0.64

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $54.92changed to$54.00

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.67 changed to 0.69
    • Malpractice RVU 0.05 changed to 0.04
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $55.19changed to$54.92

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.70 changed to 0.67
    • Malpractice RVU 0.04 changed to 0.05
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $55.13changed to$55.19

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    No ratechanged to$55.13

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$63.69$41.66RVU26D
2026-07-01$63.69$41.66RVU26C
2026-04-01$63.69$41.66RVU26B
2026-01-01$63.69$41.66RVU26A
2025-10-01$59.13$45.25RVU25D
2025-07-01$59.13$45.25RVU25C
2025-04-01$59.13$45.25RVU25B
2025-01-01$59.13$45.25RVU25A
2024-10-01$61.24$47.75RVU24D
2024-07-01$61.24$47.75RVU24C
2024-04-01$61.24$47.75RVU24B
2024-03-09$61.24$47.75RVU24AR
2024-01-01$60.24$46.97RVU24A
2023-10-01$49.00$32.55RVU23D
2023-07-01$49.00$32.55RVU23C
2023-04-01$49.00$32.55RVU23B
2023-01-01$49.00$32.55RVU23A
2022-10-01$51.42$33.88RVU22D
2022-07-01$51.42$33.88RVU22C
2022-04-01$51.42$33.88RVU22B
2022-01-01$51.42$33.88RVU22A
2021-10-01$54.00$34.16RVU21D
2021-07-01$54.00$34.16RVU21C
2021-04-01$54.00$34.16RVU21B
2021-01-01$54.00$34.16RVU21A
2020-10-01$54.92$36.41RVU20D
2020-07-01$54.92$36.41RVU20C
2020-04-01$54.92$36.41RVU20B
2020-01-01$54.92$36.41RVU20A
2019-10-01$55.19$36.08RVU19D
2019-07-01$55.19$36.08RVU19C
2019-04-01$55.19$36.08RVU19B
2019-01-01$55.19$36.08RVU19A
2018-10-01$55.13$36.04RVU18D
2018-07-01$55.13$36.04RVU18C
2018-04-01$55.13$36.04RVU18B
2018-01-01$55.13$36.04RVU18AR1
2017-10-01Not in this releaseNot in this releaseRVU17D
2017-07-01Not in this releaseNot in this releaseRVU17C
2017-04-01Not in this releaseNot in this releaseRVU17B
2017-01-01Not in this releaseNot in this releaseRVU17A
2016-10-01Not in this releaseNot in this releaseRVU16D
2016-07-01Not in this releaseNot in this releaseRVU16C
2016-04-01Not in this releaseNot in this releaseRVU16B
2016-01-01Not in this releaseNot in this releaseRVU16A
2015-10-01Not in this releaseNot in this releaseRVU15D
2015-07-01Not in this releaseNot in this releaseRVU15C
2015-04-01Not in this releaseNot in this releaseRVU15B
2015-01-01Not in this releaseNot in this releaseRVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 99484 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

99484 billing questions

How is 99484 different from 99492 or 99493?

99484 represents general behavioral health integration. Use 99492 or 99493 when the service follows the structured psychiatric collaborative care model, with its defined team and care-management approach.

What time counts toward 99484?

Count clinical-staff time spent on the qualifying behavioral health care-management work during the calendar month, under physician or qualified health professional direction. Report the code only when the monthly minimum is met.

Can 99484 be reported for each phone call or care-plan update?

No. It represents the qualifying monthly service, not a separate claim unit for each contact or activity.

What documentation supports the service?

Document the behavioral or psychiatric condition, assessment or monitoring, care planning and coordination performed, the clinical-staff time for the month, and physician or qualified health professional direction.

Are assessment, care planning, and coordination separately reported?

They are elements of the 99484 monthly service. Do not treat those included activities as separate units of this code.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 99484PPRRVU2026_Oct_nonQPP.csv, line 13,149 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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