$157.09
99492 covers the base collaborative care service in the initial month; 99494 reports additional time beyond that base.
On this page
CMS RVU26D · Effective 2026-10-01
99494 Psychiatric collaborative care Medicare reimbursement rates in Vermont
Reports additional monthly time for psychiatric collaborative care management beyond the base service, with work by the care manager and psychiatric consultant. Compare 99494 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 99494 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
$60.15
1 of 1 localities have a supported rate.
Payment area: Vermont
One mapped payment locality.
Facility setting
$35.02
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 99494: Additional collaborative care management time
Reports additional monthly time for psychiatric collaborative care management beyond the base service, with work by the care manager and psychiatric consultant.
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.
CMS billing rules for 99494
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU0.82 · 45%
- Practice expense (office) RVU0.96 · 52%
- Malpractice RVU0.06 · 3%
85.3K
Medicare services in 2024 · #610 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.
99494 compared with similar codes
Office rates for Vermont, from the same CMS release.
$141.93
99493 covers the base collaborative care service in a subsequent month; 99494 is added when additional monthly time is supported.
$56.22
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.
Compare 99494 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
$60.15
Facility
$35.02
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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 99494 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
13,158
- Code
- 99494
- Physician work
- 0.82
- Practice expense
- 0.96
- 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 | 0.82 | × 1.000 | 0.8200 |
| Practice expense | 0.96 | × 0.990 | 0.9504 |
| Malpractice | 0.06 | × 0.506 | 0.0304 |
| Total RVUs | 1.8008 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Vermont$60.15
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.82 | 1 |
| Practice expense | 0.96 | 0.99 |
| Malpractice | 0.06 | 0.506 |
(0.82 × 1 + 0.96 × 0.99 + 0.06 × 0.506) × $33.4009 = $60.15
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.82 | 1 |
| Practice expense | 0.2 | 0.99 |
| Malpractice | 0.06 | 0.506 |
(0.82 × 1 + 0.2 × 0.99 + 0.06 × 0.506) × $33.4009 = $35.02
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.
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 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.
13,15599491,,Chrnc care mgmt phys 1st 30,A,,1.50,1.08,,0.37,,0.09,2.67,1.96,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,15699492,,1st psyc collab care mgmt,A,,1.88,2.78,,0.44,,0.14,4.80,2.46,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,15799493,,Sbsq psyc collab care mgmt,A,,2.05,2.15,,0.49,,0.14,4.34,2.68,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,15899494,,1st/sbsq psyc collab care,A,,0.82,0.96,,0.20,,0.06,1.84,1.08,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,15999495,,Transj care mgmt mod f2f 14d,A,,2.78,3.62,,0.69,,0.19,6.59,3.66,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,16099496,,Transj care mgmt high f2f 7d,A,,3.79,4.91,,0.95,,0.24,8.94,4.98,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,16199497,,Advncd care plan 30 min,A,,1.50,1.01,,0.38,,0.09,2.60,1.97,0,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