CPT code 99493: Collaborative care, subsequent month2026 Medicare rate & RVUs in Maryland
Reports a subsequent month of structured psychiatric collaborative care management for a patient receiving coordinated behavioral health treatment in primary care.
Medicare pays $146.12–$161.97 for 99493 in the office in Maryland, from Rest of Maryland to Washington, DC area. 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.
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On this page 9 sections
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 in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$146.12 to $161.97
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | $152.41 | $92.91 |
| Rest of Maryland | $146.12 | $90.01 |
| Washington, DC area | $161.97 | $96.65 |
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
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
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
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