CPT code 99492: Psychiatric care management, initial month, first 70 minutes2026 Medicare rate & RVUs in Missouri
Reports the first month of structured psychiatric collaborative care when the behavioral health care manager’s qualifying activities reach at least 70 minutes.
Medicare pays $147.39–$155.88 for 99492 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
Your location
On this page 9 sections
What 99492 covers
99492 captures the initial calendar month of psychiatric collaborative care management for a patient receiving structured behavioral health treatment through a treating clinician. A behavioral health care manager, often a social worker, nurse, or other trained professional, works under the treating clinician’s direction with a psychiatric consultant. Services can include structured assessment, a measurement-based care plan, symptom tracking in a patient registry, brief evidence-based interventions, and psychiatric consultant review to guide treatment adjustments.
Report 99492 when qualifying behavioral health care manager activities total at least 70 minutes during the initial calendar month. Count the service time, not elapsed enrollment time. Documentation should identify the care manager and treating clinician, record the activities and time, and support the assessment, care plan, symptom monitoring, and consultant involvement. For subsequent calendar months, use 99493 when its time requirement is met; 99494 describes additional qualifying time reported with the applicable primary monthly code.
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.
Where 99492 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$147.39 to $155.88
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $154.55 | $81.16 |
| Metropolitan St. Louis, MO | $155.88 | $81.47 |
| Rest of Missouri | $147.39 | $80.02 |
How the 99492 rate is calculated
Each of 99492’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 · 99492
RVUs × geographic indexes × conversion factor
Work1.88
1.88 RVUs× 1.000 GPCI
Practice expense2.78
2.78 RVUs× 1.000 GPCI
Malpractice0.14
0.14 RVUs× 1.000 GPCI
Adjusted RVUs
4.8000
Conversion factor
$33.4009
Medicare rate
$160.32
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 99492
99492 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 · 99492
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$160.32
- Non-facility (office)
- $160.32
- Facility
- $82.17
Higher because the practice carries its own overhead.
99492 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 99493Collaborative careSubsequent month
- 99492 applies to the initial calendar month and its 70-minute threshold; 99493 applies to subsequent calendar months.
- 99494Psychiatric collaborative careEach additional 30 minutes
- 99494 reports additional qualifying time beyond the primary monthly collaborative care service; it does not replace 99492 for the initial month.
- 99484Behavioral health managementGeneral integration service
- 99484 is general behavioral health care management. Choose 99492 when the service follows the psychiatric collaborative care model with a care manager, treating clinician, and psychiatric consultant.
99492 billing questions
How does 99492 differ from 99493?
99492 is for qualifying care-manager activities in the initial calendar month and requires at least 70 minutes. 99493 is used for qualifying activities in subsequent calendar months.
When can 99494 be reported with 99492?
99494 reports each qualifying additional 30 minutes beyond the base monthly service time. Document the additional care-manager activities and time.
What documentation supports 99492?
Record the initial-month service time, care-manager activities, assessment, care plan, symptom monitoring, and psychiatric consultant involvement. The record should also show the treating clinician’s direction of the collaborative care.
Can general behavioral health care management be reported as 99492?
Use 99492 for the structured psychiatric collaborative care model and its required team involvement. Code 99484 is the separate general behavioral health care management service.
Does 99492 cover care-manager activity over multiple months?
No. 99492 identifies the initial calendar month; subsequent-month collaborative care is reported with 99493 when its requirements are met.
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
Fee sheets
Put 99492 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Build my fee sheet