$157.09
Choose 99492 for the initial month of psychiatric collaborative care with its structured team model; 99484 is the general behavioral health integration service.
On this page
CMS RVU26D · Effective 2026-10-01
99484 Behavioral health management Medicare reimbursement rates in Vermont
Monthly behavioral health integration for a patient with a behavioral or psychiatric condition when clinical staff provide at least 20 minutes of directed care management. Compare 99484 office and facility rates across CMS payment localities in Vermont.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 99484 in Vermont?
Vermont has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$56.22
1 of 1 localities have a supported rate.
Payment area: Vermont
One mapped payment locality.
Facility setting
$37.70
1 of 1 localities have a supported rate.
Payment area: Vermont
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Behavioral health care management
About 99484: Behavioral health integration care management
Monthly behavioral health integration for a patient with a behavioral or psychiatric condition when clinical staff provide at least 20 minutes of directed care management.
99484 covers ongoing integration of behavioral health care into a patient’s medical care. A physician or other qualified health professional directs the service, while clinical staff may perform the care-management work. Typical situations include supporting a primary care patient being treated for depression or anxiety through monitoring, care planning, and coordination with behavioral health services. The work can take place in an office-based practice or another setting where the patient’s medical care is managed.
Report the code once for a calendar month in which the required clinical-staff time is met; it is not reported per call or contact. Documentation should identify the behavioral or psychiatric condition, assessment or monitoring, care-planning and coordination work, total time, and clinician direction. Assessment, care planning, treatment coordination, and continuity activities are parts of this monthly service, rather than separate units of 99484. CMS assigns the code physician work and practice-expense values, with different practice-expense inputs for office and facility settings.
Where the value comes from
- Work RVU0.93 · 54%
- Practice expense (office) RVU0.73 · 42%
- Malpractice RVU0.06 · 3%
438.7K
Medicare services in 2024 · #243 by national volume
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.
99484 compared with similar codes
Office rates for Vermont, from the same CMS release.
$141.93
99493 describes subsequent-month psychiatric collaborative care. 99484 is not distinguished by an initial-versus-subsequent collaborative-care month.
$64.67
99490 is chronic care management for eligible chronic conditions. Use 99484 for the behavioral health integration service, not simply because a behavioral condition is chronic.
Compare 99484 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Vermont →
Office / nonfacility
$56.22
Facility
$37.70
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 99484 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
13,149
- Code
- 99484
- Physician work
- 0.93
- Practice expense
- 0.73
- Malpractice
- 0.06
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.93 | × 1.000 | 0.9300 |
| Practice expense | 0.73 | × 0.990 | 0.7227 |
| Malpractice | 0.06 | × 0.506 | 0.0304 |
| Total RVUs | 1.6831 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Vermont$56.22
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.93 | 1 |
| Practice expense | 0.73 | 0.99 |
| Malpractice | 0.06 | 0.506 |
(0.93 × 1 + 0.73 × 0.99 + 0.06 × 0.506) × $33.4009 = $56.22
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.93 | 1 |
| Practice expense | 0.17 | 0.99 |
| Malpractice | 0.06 | 0.506 |
(0.93 × 1 + 0.17 × 0.99 + 0.06 × 0.506) × $33.4009 = $37.70
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
99484 billing questions
How is 99484 different from 99492 or 99493?
99484 represents general behavioral health integration. Use 99492 or 99493 when the service follows the structured psychiatric collaborative care model, with its defined team and care-management approach.
What time counts toward 99484?
Count clinical-staff time spent on the qualifying behavioral health care-management work during the calendar month, under physician or qualified health professional direction. Report the code only when the monthly minimum is met.
Can 99484 be reported for each phone call or care-plan update?
No. It represents the qualifying monthly service, not a separate claim unit for each contact or activity.
What documentation supports the service?
Document the behavioral or psychiatric condition, assessment or monitoring, care planning and coordination performed, the clinical-staff time for the month, and physician or qualified health professional direction.
Are assessment, care planning, and coordination separately reported?
They are elements of the 99484 monthly service. Do not treat those included activities as separate units of this code.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
13,14699479,,"Sbsq ic lbw inf 1,500-2,500",A,,2.50,0.50,NA,0.50,,0.15,3.15,3.15,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,14799480,,"Sbsq ic inf pbw 2,501-5,000",A,,2.40,0.48,NA,0.48,,0.15,3.03,3.03,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,14899483,,Assmt & care pln pt cog imp,A,,3.84,4.66,,0.97,,0.27,8.77,5.08,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,14999484,,Care mgmt svc bhvl hlth cond,A,,0.93,0.73,,0.17,,0.06,1.72,1.16,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,15099485,,Suprv interfacilty transport,B,+,1.50,0.33,NA,0.33,,0.08,1.91,1.91,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
13,15199486,,Suprv interfac trnsport addl,B,+,1.30,0.29,NA,0.29,,0.07,1.66,1.66,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
13,15299487,,Cplx chrnc care 1st 60 min,A,,1.81,2.38,,0.43,,0.13,4.32,2.37,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817