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CPT code 99494: Psychiatric collaborative care, each additional 30 minutes2026 Medicare rate & RVUs in Utah

Reports additional monthly time for psychiatric collaborative care management beyond the base service, with work by the care manager and psychiatric consultant.

CMS RVU26DEffective Oct 1, 2026One payment locality85.3K Medicare services in 2024

In Utah, Medicare pays $59.33 for 99494 in the office and $35.47 when it’s performed in a hospital or facility.

$59.33Office (non-facility)
$35.47Hospital or facility
−3.5%vs the national office rate ($61.46)

Check a contract rate as a % of Medicare · 99494 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 99494 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Utah
  2. What 99494 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How Utah compares for 99494

Across 109 of 109 payment localities, the office rate for 99494 runs from $55.96 in Arkansas to $77.71 in San Benito County, CA. Utah pays $59.33. The RVUs are the same everywhere; the geographic indexes change the dollars.

99494 in Utah vs other payment areas
  1. Utah · this page$59.33
  2. Los Angeles, CA · California$67.78+$8.45
  3. Washington, DC area · District of Columbia$68.87+$9.54
  4. Miami, FL · Florida$65.84+$6.51
  5. Chicago, IL · Illinois$64.40+$5.07
  6. Manhattan, NY · New York$69.58+$10.25
  7. Alaska · Alaska$76.34+$17.01

Other areas in Utah first, then benchmark localities. Bars start at $0.

Every other payment area

99494 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$56.58$34.37
ArkansasArkansas$55.96$34.16
ArizonaArizona$60.18$35.58
Bakersfield, CACalifornia$64.27$36.45
Chico, CACalifornia$64.07$36.25
El Centro, CACalifornia$64.08$36.26
Fresno, CACalifornia$64.07$36.25
Hanford, CACalifornia$64.07$36.25

99494 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$55.96

$76.34

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

View every state and territory as a table
99494 office rate range by state
State / territoryOffice rate rangeLocalities
AK$76.341
AL$56.581
AR$55.961
AZ$60.181
CA$64.07–$77.7129
CO$63.401
CT$64.901
DC$68.871
DE$61.011
FL$61.05–$65.843
GA$58.38–$62.462
GU$65.011
HI$65.011
IA$57.521
ID$57.841
IL$59.80–$64.404
IN$58.091
KS$57.391
KY$57.731
LA$57.69–$59.842
MA$63.19–$68.582
MD$61.95–$68.873
ME$58.13–$60.432
MI$58.93–$61.712
MN$60.981
MO$56.98–$59.923
MS$56.481
MT$61.451
NC$58.591
ND$60.271
NE$57.741
NH$62.521
NJ$65.70–$68.452
NM$59.201
NV$61.161
NY$59.26–$70.995
OH$58.681
OK$57.581
OR$60.73–$64.942
PA$58.72–$63.652
PR$61.781
RI$62.821
SC$58.721
SD$60.131
TN$57.611
TX$58.43–$63.148
UT$59.331
VA$60.32–$68.872
VI$61.781
VT$60.151
WA$63.03–$69.742
WI$58.721
WV$58.121
WY$60.941

See 99494 in every payment locality

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

Office or facility?

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.

The exact Utah inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

13,158

Code
99494
Physician work
0.82
Practice expense
0.96
Malpractice
0.06

GPCI2026.csv

104

Locality
Utah
Physician work
1.000
Practice expense
0.940
Malpractice
0.898
Office calculation for 99494 in Utah
ComponentRVULocality factorAdjusted
Physician work0.82× 1.0000.8200
Practice expense0.96× 0.9400.9024
Malpractice0.06× 0.8980.0539
Total RVUs1.7763
Conversion factor× 33.4009

Office rate, Utah$59.33

Office: (0.82 × 1 + 0.96 × 0.94 + 0.06 × 0.898) × $33.4009 = $59.33

Facility: (0.82 × 1 + 0.2 × 0.94 + 0.06 × 0.898) × $33.4009 = $35.47

Open 99494 in the RVU calculator

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

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

Codes related to 99494

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

Codes related to 99494
CodeHow it relatesOffice range, Utah
Add-on codes
99492Psychiatric care management, initial month, first 70 minutesBase code for psychiatric collaborative care management in the initial month.$154.28
99493Collaborative care, subsequent monthBase code for psychiatric collaborative care management in a subsequent month.$140.17
Used instead
99484Behavioral health management, general integration serviceGeneral behavioral health care management service with a different care-management model.$55.78

How 99494 has changed in Utah

99494 · Office / nonfacility

$59.33

Effective 2026-10-01

The base rate is $5.35 higher than on 2025-10-01, moving from $53.98 to $59.33 (9.9%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $53.98changed to$59.33

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.87 changed to 0.96
    • Malpractice RVU 0.04 changed to 0.06
    • Practice expense GPCI 0.933 changed to 0.940
    • Malpractice GPCI 0.930 changed to 0.898

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $57.11changed to$53.98

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.91 changed to 0.87
    • Malpractice RVU 0.05 changed to 0.04

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $56.17changed to$57.11

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $55.59changed to$56.17

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.83 changed to 0.91
    • Malpractice RVU 0.06 changed to 0.05
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.865 changed to 0.930

  5. January 1, 2023

    RVU23A

    $60.61changed to$55.59

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.97 changed to 0.83
    • Malpractice RVU 0.05 changed to 0.06
    • Practice expense GPCI 0.919 changed to 0.926
    • Malpractice GPCI 0.799 changed to 0.865

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $56.30changed to$60.61

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.82 changed to 0.97

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $61.35changed to$56.30

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.90 changed to 0.82
    • Practice expense GPCI 0.923 changed to 0.919
    • Malpractice GPCI 0.982 changed to 0.799

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $64.73changed to$61.35

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.99 changed to 0.90
    • Practice expense GPCI 0.927 changed to 0.923
    • Malpractice GPCI 1.165 changed to 0.982

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $64.32changed to$64.73

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.98 changed to 0.99

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    No ratechanged to$64.32

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$59.33$35.47RVU26D
2026-07-01$59.33$35.47RVU26C
2026-04-01$59.33$35.47RVU26B
2026-01-01$59.33$35.47RVU26A
2025-10-01$53.98$37.99RVU25D
2025-07-01$53.98$37.99RVU25C
2025-04-01$53.98$37.99RVU25B
2025-01-01$53.98$37.99RVU25A
2024-10-01$57.11$39.71RVU24D
2024-07-01$57.11$39.71RVU24C
2024-04-01$57.11$39.71RVU24B
2024-03-09$57.11$39.71RVU24AR
2024-01-01$56.17$39.07RVU24A
2023-10-01$55.59$39.59RVU23D
2023-07-01$55.59$39.59RVU23C
2023-04-01$55.59$39.59RVU23B
2023-01-01$55.59$39.59RVU23A
2022-10-01$60.61$40.89RVU22D
2022-07-01$60.61$40.89RVU22C
2022-04-01$60.61$40.89RVU22B
2022-01-01$60.61$40.89RVU22A
2021-10-01$56.30$39.63RVU21D
2021-07-01$56.30$39.63RVU21C
2021-04-01$56.30$39.63RVU21B
2021-01-01$56.30$39.63RVU21A
2020-10-01$61.35$42.36RVU20D
2020-07-01$61.35$42.36RVU20C
2020-04-01$61.35$42.36RVU20B
2020-01-01$61.35$42.36RVU20A
2019-10-01$64.73$43.34RVU19D
2019-07-01$64.73$43.34RVU19C
2019-04-01$64.73$43.34RVU19B
2019-01-01$64.73$43.34RVU19A
2018-10-01$64.32$42.96RVU18D
2018-07-01$64.32$42.96RVU18C
2018-04-01$64.32$42.96RVU18B
2018-01-01$64.32$42.96RVU18AR1
2017-10-01Not in this releaseNot in this releaseRVU17D
2017-07-01Not in this releaseNot in this releaseRVU17C
2017-04-01Not in this releaseNot in this releaseRVU17B
2017-01-01Not in this releaseNot in this releaseRVU17A
2016-10-01Not in this releaseNot in this releaseRVU16D
2016-07-01Not in this releaseNot in this releaseRVU16C
2016-04-01Not in this releaseNot in this releaseRVU16B
2016-01-01Not in this releaseNot in this releaseRVU16A
2015-10-01Not in this releaseNot in this releaseRVU15D
2015-07-01Not in this releaseNot in this releaseRVU15C
2015-04-01Not in this releaseNot in this releaseRVU15B
2015-01-01Not in this releaseNot in this releaseRVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 99494 for an earlier date of service

Where the Utah rate applies

Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.

  • Alpine
  • Alta
  • Altamont
  • Alton
  • Amalga
  • American Fork
  • Aneth
  • Annabella

Browse all communities in Utah

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

Show the CMS file lines behind this rate
RVUs for 99494PPRRVU2026_Oct_nonQPP.csv, line 13,158 (RVU26D)
Geographic factors for UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

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