Did you know? The CDC estimates that up to 20 percent of adults will have a mental health concern at some point during their lives. These are mostly the people who are found in the primary care clinics, and not in the special mental health practices.
Introduction
The Collaborative Care Management (CoCM) is revolutionizing the sector of how both behavioral and physical health are managed, combined within a single care plan. CoCM is one of the reimbursable models through which primary care providers, behavioral health care managers, and psychiatric consultants cooperate with each other and provide mental health support within the same system.
However, the condition is that in order to be paid for this service, you need to bill properly.
Proper use of codes such as CPT 99492, 99493, 99494, and G2214 will result in ensuring that you are reimbursed the appropriate amount of money you spent on collaborative care management. So read on, as this guide by Provider Care Billing, a top provider of medical billing and coding services, will walk you through the CoCM billing process and keep your practice from experiencing denials and delays.
CPT Code 99492
The first month of the psychiatric collaborative care is covered with CPT 99492.
Time Used: 70 minutes
To Use When: Consider utilizing care management services for effective outcomes. Start of CoCM treatment. Start of CoCM treatment
Includes:
- Behavioral evaluation
- Care plan building
- Psychiatric consultation
- Caregiver-patient communication
- Applications of validated rating scales
- Documentation of time and services provided
A PCP begins the collaborative treatment of a patient diagnosed with severe depressive illness. A care manager conducts assessments and communicates with a psychiatrist, and each visit is recorded and timed for 72 minutes.
CPT Code 99493
CPT 99493 is for the following month’s collaborative care.
Time Used: 60 minutes
To Use When: Keeping up management beyond the first month
Includes:
- Monitoring and changes of the care plan
- Visits to psychiatry consultants
- Behavioral assessments
- Patient/Family Communication
If given that the care manager uses 60 minutes only in the second month, then 99493 is charged.
CPT Code 99494
CPT 99494 is an add-on code for any additional 30 minutes beyond the basic time of 99492 or 99493.
Time Used: Half-hour intervals
To Use When: In case of care services above 70 mins (99492) or 60 mins (99493)
In the second month, a care manager gives you 105 minutes of services. Bill 99493+99494.
HCPCS Code G2214
G2214 is a part of the specific codes of CMS partial services in case there are no full thresholds.
Time Used: At least 30 minutes
To Use When:
- A 70 or 60 minutes is not fulfilled fully
- Off-days months
- Short-term decrease in the service volume
In the third month, the care manager devotes only 34 minutes of work to the case of a patient. Bill G2214.
CoCM Code Comparison Table
| Code | Time | Use Case | Month Type | Add-On? |
| 99492 | 70 minutes | Initial CoCM setup | 1st Month | ❌ No |
| 99493 | 60 minutes | Ongoing care | Later Months | ❌ No |
| 99494 | +30 minutes | Extra time | Any | ✅ Yes |
| G2214 | 30 minutes | Partial service | Any | ❌ No |
A small Ohio primary care clinic was facing challenges in dealing with anxiety and depression. Having discussed with Medical Billing Company, they established a well-organized CoCM model and trained their care managers.
In 3 months, they:
- Added $4,500/month in revenue CPT 99493 and 99494.
- Experienced a reduction of depression scores by 37 percent in patients.
- Improved inter-teamwork and physician burnout.
The secret? Well-documented, well-trained personnel and a committed billing partner.
Tips for Accurate Billing
In order to successfully bill behavioral health integration services, consider the best practices:
- Document Time Accurately
Whether with an EHR integrated time tracker or a care manager worksheet, you must record everything: calls, charting, psychiatric consults, and so on.
- Reporting team roles
Document the input of all teammates (care manager, PCP, psychiatrist). It legitimizes teamwork and makes billable hours.
- Check Consent
There has to be documented verbal or written consent prior to Medicare billing CoCM.
- Avoid Common Denials
- Do not charge 99492 and 99493 with each other.
- Support code limits with a specific actual time.
- Code a behavioral health ICD-10 code (e.g., F32.1, F41.1).
- Collaboration with Experts
To avoid facing denials, outsource to a medical billing company such as Providers Care Billing LLC to help use behavioral health CPT codes 2025 appropriately.
If you are already practicing reading collaborative or integrated behavioral care, leave the dollars on the table.
Call the professionals of medical billing companies, who are your faithful companions:
- The behavioral health code
- Revenue Cycle Management Services
- Psychiatry and psychology Psychiatry and psychology
- Compliance and credentialing
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Conclusion
The future of care is behavioral health integration, and CoCM codes are important to know in order to deliver care. Are you a sole provider, small group practice, or FQHC? Then get your CPTs 99492, 99493, 99494, and G2214 down as fast as possible so you are getting what your time and effort to care for patients is worth.
Providers Care Billing LLC is there to guide and get you through these codes without making expensive errors, and find a simpler way to deal with your behavioral health billing mechanism.
For accurate diagnosis coding in behavioral health, don’t miss our comparison of F91.1 and F91.3 for Conduct Disorder vs. ODD.
Frequently Asked Questions (FAQS)
- What is cpt code of behavioral health case management?
CPT 99492 should be used when giving initial care, 99493 should be used to administer subsequent management, and 99494 should be used when extra time is spent. G2214- Short services.
- Can psychologists make CoCM billing?
Or only as a part of a primary care-based model. The person can be a psychologist or a supervised social worker as a behavioral health care manager.
- What does G2214 mean?
G2214 is the add-on that applies to CMS in the case of 99492/99493, where time is not fully provided. It enables reimbursement flexibility for shorter interactions.
- How many times can I bill 99492?
This is only one time within the life of the patient, and that too only during the initial period of CoCM treatment (the first month).
