CPT 99494: Psychiatric Collaborative Care, Each Additional 30 Minutes
CPT 99494 is an add-on for each additional 30 minutes of psychiatric Collaborative Care Model (CoCM) care-manager time in a calendar month, reported with 99492 or 99493. In 2026 Medicare pays about $61.46 non-facility (1.84 total RVUs times the $33.4009 conversion factor) and about $36.07 in a facility.
- Code type
- Psychiatric CoCM add-on (+30 min)
- 2026 non-facility
- $61.46 (1.84 RVUs)
- 2026 facility
- $36.07 (1.08 RVUs)
- Reported with
- 99492 or 99493
What is CPT 99494 used for?
CPT 99494 is the add-on for additional CoCM care-manager time. Once the base code's time is met, either 70 minutes for 99492 or 60 minutes for 99493, each further full 30-minute block in the same month is reported with 99494. It scales collaborative-care payment to the actual care-management effort.
The add-on always accompanies a CoCM base code and is never billed alone. Because many collaborative-care patients exceed the base-code time, especially in busier subsequent months, 99494 is a routine companion rather than an exception, and more than one unit may be reported when the documented care-manager time supports multiple full 30-minute increments.
How much does 99494 pay in 2026?
99494 carries 1.84 non-facility RVUs and 1.08 facility RVUs. At the 2026 conversion factor of $33.4009 that is about $61.46 non-facility and $36.07 in a facility per 30-minute unit. Model the stacked monthly total on the Medicare fee calculator.
How does 99494 stack on CoCM?
| Scenario | Codes | 2026 non-facility total |
|---|---|---|
| Initial month, 100 min | 99492 + 99494 | ~$221.78 |
| Subsequent month, 90 min | 99493 + 99494 | ~$206.42 |
| Subsequent month, 120 min | 99493 + 99494 x2 | ~$267.88 |
Example: a subsequent month with 92 documented care-manager minutes supports 99493 plus one 99494, about $206.42, but not a second add-on, because the extra 32 minutes clears only one full 30-minute block. In a heavier month with 121 documented minutes, the same base code supports two 99494 units, since the extra 61 minutes contains two complete 30-minute increments.
The add-on carries the same clinical requirements as the base code it accompanies: the time must be the behavioral health care manager's, delivered within an active Collaborative Care Model that includes a treating practitioner and a psychiatric consultant. Documenting the care manager's minutes separately from any physician time is what keeps each 99494 unit defensible on review.
Frequently asked questions
99494 is an add-on reported with either 99492 (initial month) or 99493 (subsequent month) for each additional full 30 minutes of behavioral health care-manager time beyond the base code's threshold in a calendar month. It must always accompany a CoCM base code; it is never billed alone.
The 2026 national non-facility allowed amount is about $61.46 (1.84 total RVUs times $33.4009) and about $36.07 in a facility per 30-minute unit. Because many CoCM patients exceed the base-code time, 99494 is a routine add-on.
Yes, when the documented care-manager time supports multiple full 30-minute increments beyond the base code, additional 99494 units may be reported. Each unit needs a complete 30-minute block backed by a dated time log. Partial increments do not qualify.
Sources & further reading
Reviewed by the ImmediCare Solutions RCM team
Certified billers and coders handling claims across 50+ specialties nationwide. This entry is reviewed against current payer policy and CMS rules. Last review: Jul 5, 2026.
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