Billing code 99492: Psychiatric care managementMedicare rate & RVUs

Medicare pays $160.32 for 99492 nationally in the office and $82.17 in a hospital or facility. Local office rates run $144.96–$206.10.

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

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

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

109 of 109 payment localities

99492 rates by state

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

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.

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.

99492 compared with similar codes

How to choose

99493Collaborative care

99492 applies to the initial calendar month and its 70-minute threshold; 99493 applies to subsequent calendar months.

99494Psychiatric collaborative care

99494 reports additional qualifying time beyond the primary monthly collaborative care service; it does not replace 99492 for the initial month.

99484Behavioral health management

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.

Codes related to 99492

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

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

Open CMS sourceHow we calculate rates