CPT code 99493: Collaborative care, subsequent month2026 Medicare rate & RVUs

Reports a subsequent month of structured psychiatric collaborative care management for a patient receiving coordinated behavioral health treatment in primary care.

CMS RVU26DEffective Oct 1, 2026109 payment localities123K Medicare services in 2024

Medicare pays $144.96 for 99493 nationally in the office and $89.51 in a hospital or facility. Local office rates run $132.57–$182.06.

Medicare rate · 99493

Collaborative care, subsequent month

Office or facility?

Work RVUs
2.05
Total RVUs
4.34
Global days
XXX

National rate · 2026

$144.96

Office setting, before claim adjustments.

See every locality for 99493 →Billed by an NP, PA or therapist? →

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

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 99493 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 99493 covers

A behavioral health care manager coordinates ongoing treatment for a patient with a behavioral health condition, commonly depression or anxiety, in a primary care setting. The work may include patient outreach, tracking symptoms with validated measures, updating the care plan, and coordinating with the treating clinician. A psychiatric consultant reviews the caseload and advises the treating clinician; the consultant does not necessarily meet with the patient.

Report 99493 for the qualifying collaborative care management service in a subsequent calendar month, after the initial month represented by 99492. Documentation should show the care plan, ongoing monitoring and coordination, team consultation, and the care manager’s qualifying work and time for that month. The code represents a structured, team-based service rather than a psychotherapy visit. When the service extends beyond the time represented by 99493, 99494 may be relevant for additional qualifying time.

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 99493 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 payment localities

$132.57 to $182.06

$132.57$157.31$182.06
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

99493 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$133.95$85.44
Alaska$181.76$122.71
Arizona$142.06$88.33
Arkansas$132.57$84.94
Atlanta, GA$147.25$90.92
Austin, TX$148.73$90.07
Bakersfield, CA$151.33$90.56
Baltimore area, MD$152.41$92.91
Beaumont, TX$138.16$87.71
Brazoria, TX$143.83$88.89

99493 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.

$132.57

$181.76

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

View every state and territory as a table
99493 office rate range by state
State / territoryOffice rate rangeLocalities
AK$181.761
AL$133.951
AR$132.571
AZ$142.061
CA$150.85–$182.0629
CO$149.351
CT$152.841
DC$161.971
DE$143.971
FL$144.15–$155.053
GA$138.10–$147.252
GU$152.831
HI$152.831
IA$136.041
ID$136.751
IL$141.34–$151.854
IN$137.311
KS$135.751
KY$136.591
LA$136.51–$141.362
MA$148.91–$161.182
MD$146.12–$161.973
ME$137.45–$142.592
MI$139.32–$145.652
MN$143.751
MO$134.93–$141.523
MS$133.761
MT$144.951
NC$138.461
ND$142.181
NE$136.521
NH$147.321
NJ$154.76–$161.082
NM$139.941
NV$144.251
NY$139.98–$166.925
OH$138.751
OK$136.231
OR$143.28–$152.832
PA$138.81–$150.042
PR$145.681
RI$148.131
SC$138.801
SD$141.851
TN$136.261
TX$138.16–$148.738
UT$140.171
VA$142.36–$161.972
VI$145.681
VT$141.931
WA$148.54–$163.832
WI$138.711
WV$137.571
WY$143.741

How the 99493 rate is calculated

Each of 99493’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 · 99493

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.05

2.05 RVUs× 1.000 GPCI

Practice expense2.15

2.15 RVUs× 1.000 GPCI

Malpractice0.14

0.14 RVUs× 1.000 GPCI

Adjusted RVUs

4.3400

Conversion factor

$33.4009

Medicare rate

$144.96

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

Payment rules and modifiers for 99493

99493 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 · 99493

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

$144.96

Non-facility (office)
$144.96
Facility
$89.51

Higher because the practice carries its own overhead.

99493 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 99493

    Collaborative care, subsequent month2.05 wRVU

    $144.96

  • 99492

    Psychiatric care management, initial month, first 70 minutes1.88 wRVU

    $160.32+$15.36

  • 99494

    Psychiatric collaborative care, each additional 30 minutes0.82 wRVU

    $61.46−$83.50

  • 99484

    Behavioral health management, general integration service0.93 wRVU

    $57.45−$87.51

How to choose

99492Psychiatric care managementInitial month, first 70 minutes
99492 represents the initial calendar month of psychiatric collaborative care management; 99493 represents a subsequent month.
99494Psychiatric collaborative careEach additional 30 minutes
99494 reports additional qualifying time beyond the primary monthly collaborative care service; 99493 represents the subsequent-month service itself.
99484Behavioral health managementGeneral integration service
99484 describes general behavioral health integration management. 99493 is for the more structured psychiatric collaborative care model with a care manager and psychiatric consultant.

99493 billing questions

When should the practice use 99493 instead of 99492?

Use 99493 for a subsequent calendar month of psychiatric collaborative care management. The initial month is represented by 99492.

Does a psychiatrist have to see the patient?

No. The psychiatric consultant may review the caseload and provide recommendations to the treating clinician without a direct patient visit.

What documentation supports 99493?

Document the behavioral health care plan, symptom monitoring, outreach or coordination, team consultation, and qualifying care management work and time during the month.

Can 99494 be reported with 99493?

99494 may be reported for additional qualifying psychiatric collaborative care management time beyond the time represented by 99493. The record should support the additional work and time.

Is 99493 a psychotherapy session?

No. It represents ongoing team-based care management, such as measurement-based follow-up and coordination, rather than a standalone psychotherapy service.

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 99493PPRRVU2026_Oct_nonQPP.csv, line 13,157 (RVU26D)

Open CMS sourceHow we calculate rates

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