CPT 99492 is the code for the first calendar month of psychiatric collaborative care management (CoCM). It covers the first 70 minutes of behavioural health care manager activities in that month, in consultation with a psychiatric consultant and directed by the treating physician or other qualified health care professional.

Under Medicare, physicians and non-physician practitioners whose scope of practice includes E/M services: physicians of any specialty, nurse practitioners, physician assistants, clinical nurse specialists, and certified nurse midwives. CMS describes the billing practitioner as typically working in primary care, though other specialties can bill. The care manager and psychiatric consultant work under the billing practitioner and do not bill 99492 themselves.

What are the required elements of 99492?

Per CMS: outreach to and engagement of the patient; an initial assessment including validated rating scales and an individualized treatment plan; review by the psychiatric consultant with modifications if recommended; entering the patient in a registry and tracking follow-up and progress, with weekly caseload consultation with the psychiatric consultant; and brief evidence-based interventions such as behavioural activation and motivational interviewing.

What comes after 99492?

99493 bills subsequent months (first 60 minutes of care manager time each month). Add-on 99494 bills each additional 30 minutes in any CoCM month. Medicare's HCPCS G2214 covers the first 30 minutes in a month, for example when the patient is hospitalized or referred out before the full time is reached.

Does CoCM need patient consent?

Yes. Before starting, the patient must agree to the billing practitioner consulting relevant specialists, including the psychiatric consultant, and must be told that cost sharing applies. CMS accepts verbal consent if it is documented in the record. New consent is needed only if the patient changes billing practitioners.

Can 99492 and 99484 be billed in the same month?

No. CMS does not allow general BHI (99484) in the same month as CoCM codes for the same patient. A client can move between the two models across different months.

How often can 99492 be billed?

Once, for the initial month of a CoCM episode. Medicare's MUE for 99492 is 1 unit per date of service, with adjudication indicator 2 (a policy edit). Later months use 99493 and 99494.

99492·CPT (AMA)

Psychiatric Collaborative Care (CoCM), First Month

CPT 99492 bills the first month of the Collaborative Care Model: 70 minutes of care manager time with a psychiatric consultant. Required elements, team roles, and codes.

CPT 99492 at a glance

CPT 99492
Collaborative care
Psychiatric Collaborative Care (CoCM), First Month
Typical reimbursement
Varies by payer
US national commercial medians; varies by payer, plan and contract.
Scales that bill here
5 validated scales
A claim needs both a CPT and an ICD-10 code. ICD-10 reference

What the Collaborative Care Model is

The Collaborative Care Model (CoCM) adds two things to usual primary care: a behavioural health care manager and a psychiatric consultant. The primary care team screens and assesses, the care manager tracks every enrolled client in a registry and delivers brief interventions, and the psychiatric consultant reviews the caseload each week and recommends changes. The consultant can be, and typically is, remote, and is not generally expected to see the client directly.

CoCM is measurement-based care by design. CMS lists validated rating scales in the initial assessment, and systematic follow-up using validated rating scales and a registry, as part of the model.

Time requirements

Code	Care manager time	When
99492	First 70 minutes	Initial calendar month
99493	First 60 minutes	Each subsequent calendar month
+99494	Each additional 30 minutes	Any CoCM month, with 99492 or 99493
G2214 (Medicare)	First 30 minutes	Initial or subsequent month

CMS states that CPT time rules apply to CoCM. Time spent solely on administrative or clerical work does not count.

Required elements of 99492

CMS lists these for the initial month:

Outreach and engagement of the client, directed by the treating practitioner.
Initial assessment including validated rating scales, such as the PHQ-9 and GAD-7, and an individualized treatment plan.
Psychiatric consultant review of the plan, with modifications if recommended.
Registry entry and tracking of follow-up and progress, with weekly caseload consultation with the psychiatric consultant.
Brief interventions using evidence-based techniques such as behavioural activation and motivational interviewing.

Before the first month

Initiating visit. CMS requires an initiating visit with the billing practitioner before BHI services start: an annual wellness visit, initial preventive physical exam, a comprehensive E/M visit, or a transitional care management visit.
Consent. Verbal consent is acceptable if documented, and must cover consultation with specialists and the fact that cost sharing applies.
Team roles. The billing practitioner directs care; the behavioural health care manager is required for CoCM; the psychiatric consultant is required for CoCM. Care team members are employed by or contracted to the billing practitioner and work under general supervision.

Billing rules

Monthly, not per visit. 99492 is billed once for the calendar month in which the threshold is met.
Not with general BHI in the same month. Use CPT 99484 in months when the practice is not delivering CoCM for that client.
MUE: 1 unit (adjudication indicator 2). 99494's MUE is 4 units per date of service.
Advanced primary care management. From January 1, 2026, CMS added optional HCPCS add-on codes for CoCM and general BHI delivered in the same month as advanced primary care management. Check the current CMS booklet for those codes.

Measurement in CoCM

The registry is the working centre of CoCM. Each enrolled client needs a baseline score, regular repeat scores on the same scale, and a flag when they are not improving so the weekly caseload review can act on it. Brief scale scoring at a separate visit is billed under CPT 96127; check NCCI edits and payer policy before billing it in a CoCM month.

Assessments that bill under CPT 99492

These validated scales are commonly administered, scored, and documented under this code.

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Frequently asked questions

What is CPT 99492?
CPT 99492 is the code for the first calendar month of psychiatric collaborative care management (CoCM). It covers the first 70 minutes of behavioural health care manager activities in that month, in consultation with a psychiatric consultant and directed by the treating physician or other qualified health care professional.
Who can bill 99492?
Under Medicare, physicians and non-physician practitioners whose scope of practice includes E/M services: physicians of any specialty, nurse practitioners, physician assistants, clinical nurse specialists, and certified nurse midwives. CMS describes the billing practitioner as typically working in primary care, though other specialties can bill. The care manager and psychiatric consultant work under the billing practitioner and do not bill 99492 themselves.
What are the required elements of 99492?
Per CMS: outreach to and engagement of the patient; an initial assessment including validated rating scales and an individualized treatment plan; review by the psychiatric consultant with modifications if recommended; entering the patient in a registry and tracking follow-up and progress, with weekly caseload consultation with the psychiatric consultant; and brief evidence-based interventions such as behavioural activation and motivational interviewing.
What comes after 99492?
99493 bills subsequent months (first 60 minutes of care manager time each month). Add-on 99494 bills each additional 30 minutes in any CoCM month. Medicare's HCPCS G2214 covers the first 30 minutes in a month, for example when the patient is hospitalized or referred out before the full time is reached.
Does CoCM need patient consent?
Yes. Before starting, the patient must agree to the billing practitioner consulting relevant specialists, including the psychiatric consultant, and must be told that cost sharing applies. CMS accepts verbal consent if it is documented in the record. New consent is needed only if the patient changes billing practitioners.
Can 99492 and 99484 be billed in the same month?
No. CMS does not allow general BHI (99484) in the same month as CoCM codes for the same patient. A client can move between the two models across different months.
How often can 99492 be billed?
Once, for the initial month of a CoCM episode. Medicare's MUE for 99492 is 1 unit per date of service, with adjudication indicator 2 (a policy edit). Later months use 99493 and 99494.

Sources

1. 1.American Medical Association. Current Procedural Terminology (CPT) 2026, codes 99492, 99493, and 99494.
2. 2.Centers for Medicare & Medicaid Services. MLN909432 Booklet: BHI Services, January 2026 (CoCM model, required elements, time thresholds, initiating visit, consent, billing practitioners, team roles, G2214).
3. 3.Centers for Medicare & Medicaid Services. Medicare NCCI Practitioner Services Medically Unlikely Edits, table effective 2026-10-01 (99492 = 1 unit, adjudication indicator 2; 99494 = 4 units, adjudication indicator 3). MUE values are revised quarterly; confirm the current table before relying on this figure.

Psychiatric Collaborative Care (CoCM), First Month

CPT 99492 at a glance

CPT 99492

Typical reimbursement

Scales that bill here

What the Collaborative Care Model is

Time requirements

Required elements of 99492

Before the first month

Billing rules

Measurement in CoCM

Assessments that bill under CPT 99492

PHQ-9: Patient Health Questionnaire-9

GAD-7 Scoring and Interpretation

PCL-5: PTSD Checklist for DSM-5-TR

AUDIT Scoring & AUDIT-C · Alcohol Use Disorders Identification Test

MDQ: Mood Disorder Questionnaire