CPT code 99494: Psychiatric collaborative care, each additional 30 minutes2026 Medicare rate & RVUs
Reports additional monthly time for psychiatric collaborative care management beyond the base service, with work by the care manager and psychiatric consultant.
Medicare pays $61.46 for 99494 nationally in the office and $36.07 in a hospital or facility. Local office rates run $55.96–$77.71.
Medicare rate · 99494
Psychiatric collaborative care, each additional 30 minutes
- Work RVUs
- 0.82
- Total RVUs
- 1.84
- Global days
- ZZZ
National rate · 2026
$61.46
Office setting, before claim adjustments.
See every locality for 99494 →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.
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On this page 10 sections
What 99494 covers
This add-on captures additional time spent delivering psychiatric collaborative care management during a calendar month. The work typically involves a behavioral health care manager coordinating with a psychiatric consultant and the treating physician or other qualified health care professional. Activities may include patient outreach, tracking symptoms with measurement-based tools, reviewing cases with the consultant, and communicating treatment recommendations. These services commonly support patients receiving primary care for depression or another behavioral health condition.
Report 99494 only with the applicable base service: 99492 for the initial month or 99493 for a subsequent month. The record should support the additional time and the collaborative care activities performed during that month, including care-manager and psychiatric-consultant involvement. CMS treats this as an add-on code: it must be billed with a primary procedure and is paid within that procedure's global period.
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 99494 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
$55.96 to $77.71
109 of 109 payment localities
99494 rates by state
Office rate range in each state. Select a state to see its payment localities.
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Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$55.96
$76.34
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $76.34 | 1 |
| AL | $56.58 | 1 |
| AR | $55.96 | 1 |
| AZ | $60.18 | 1 |
| CA | $64.07–$77.71 | 29 |
| CO | $63.40 | 1 |
| CT | $64.90 | 1 |
| DC | $68.87 | 1 |
| DE | $61.01 | 1 |
| FL | $61.05–$65.84 | 3 |
| GA | $58.38–$62.46 | 2 |
| GU | $65.01 | 1 |
| HI | $65.01 | 1 |
| IA | $57.52 | 1 |
| ID | $57.84 | 1 |
| IL | $59.80–$64.40 | 4 |
| IN | $58.09 | 1 |
| KS | $57.39 | 1 |
| KY | $57.73 | 1 |
| LA | $57.69–$59.84 | 2 |
| MA | $63.19–$68.58 | 2 |
| MD | $61.95–$68.87 | 3 |
| ME | $58.13–$60.43 | 2 |
| MI | $58.93–$61.71 | 2 |
| MN | $60.98 | 1 |
| MO | $56.98–$59.92 | 3 |
| MS | $56.48 | 1 |
| MT | $61.45 | 1 |
| NC | $58.59 | 1 |
| ND | $60.27 | 1 |
| NE | $57.74 | 1 |
| NH | $62.52 | 1 |
| NJ | $65.70–$68.45 | 2 |
| NM | $59.20 | 1 |
| NV | $61.16 | 1 |
| NY | $59.26–$70.99 | 5 |
| OH | $58.68 | 1 |
| OK | $57.58 | 1 |
| OR | $60.73–$64.94 | 2 |
| PA | $58.72–$63.65 | 2 |
| PR | $61.78 | 1 |
| RI | $62.82 | 1 |
| SC | $58.72 | 1 |
| SD | $60.13 | 1 |
| TN | $57.61 | 1 |
| TX | $58.43–$63.14 | 8 |
| UT | $59.33 | 1 |
| VA | $60.32–$68.87 | 2 |
| VI | $61.78 | 1 |
| VT | $60.15 | 1 |
| WA | $63.03–$69.74 | 2 |
| WI | $58.72 | 1 |
| WV | $58.12 | 1 |
| WY | $60.94 | 1 |
How the 99494 rate is calculated
Each of 99494’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 · 99494
RVUs × geographic indexes × conversion factor
Work0.82
0.82 RVUs× 1.000 GPCI
Practice expense0.96
0.96 RVUs× 1.000 GPCI
Malpractice0.06
0.06 RVUs× 1.000 GPCI
Adjusted RVUs
1.8400
Conversion factor
$33.4009
Medicare rate
$61.46
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 99494
The CMS indicators that decide how 99494 is paid alongside other services.
CMS payment indicators · 99494
Psychiatric collaborative care, each additional 30 minutes
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
99494 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 99492Psychiatric care managementInitial month, first 70 minutes
- 99492 covers the base collaborative care service in the initial month; 99494 reports additional time beyond that base.
- 99493Collaborative careSubsequent month
- 99493 covers the base collaborative care service in a subsequent month; 99494 is added when additional monthly time is supported.
- 99484Behavioral health managementGeneral integration service
- 99484 is general behavioral health care management. Use 99494 only as an add-on to the psychiatric collaborative care services represented by 99492 or 99493.
99494 billing questions
Which base code can be billed with 99494?
Report it with 99492 for the initial month of psychiatric collaborative care management or 99493 for a subsequent month. It is not a standalone service.
When is 99494 appropriate instead of 99493?
99493 is the base service for a subsequent month. Add 99494 when the documented collaborative care work extends beyond the time represented by that base service.
How should the additional time be documented?
Keep a monthly record supporting the additional time and the collaborative care activities, such as care-manager work, psychiatric-consultant case review, and coordination with the treating clinician.
Can 99494 be reported by itself?
No. CMS identifies it as an add-on code that must be submitted with a primary procedure and is paid within that procedure's global period.
How does 99494 differ from 99484?
99494 adds time to the psychiatric collaborative care model represented by 99492 or 99493. 99484 is a separate general behavioral health care management 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
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