CPT code 99484: Behavioral health management, general integration service2026 Medicare rate & RVUs in Puerto Rico

In Puerto Rico, Medicare pays $57.69 for 99484 in the office and $38.78 when it’s performed in a hospital or facility.

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.

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 Puerto Rico 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. Puerto Rico pays $57.69. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

99484 rates by state

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

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.

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.

Codes related to 99484

Related codes aren’t interchangeable: bill the code that matches the service performed.

How 99484 has changed in Puerto Rico

Price 99484 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

• Aceitunas
• Adjuntas
• Aguada
• Aguadilla
• Aguas Buenas
• Aguas Claras
• Aguilita
• Aibonito

Browse all communities in Puerto Rico

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

Open CMS sourceHow we calculate rates