Reimbursement
$149.30
Threshold
70m
2026 Status
Active
What is CPT Code 99492?
CPT 99492 is defined as: Initial psychiatric collaborative care management, first 70 minutes in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant and directed by the treating physician or other qualified health care professional.
This code is primarily used for BHI services. It falls under the category of Behavioral Health Integration (CoCM) and is valid for the 2026 calendar year according to the CMS Physician Fee Schedule.
2026 RVU Components
Relative Value Units (Non-Facility)
Work RVU
1.88
Physician Effort
PE (Non-Fac)
2.48
Practice Expense
Malpractice
0.11
Risk Factor
Total RVU
4.47
Note: [(Work RVU * Work GPCI) + (PE RVU * PE GPCI) + (MP RVU * MP GPCI)] * Conversion Factor
2026 CMS Policy Intelligence
efficiency shield
Protected from the -2.5% productivity adjustment (Behavioral Health service).
high value integration
CoCM pays $153.64, reflecting the high administrative and clinical overhead of the three-party collaborative model.
fqhc rhc transition
FQHCs can now capture the significant effort of CoCM using itemized 99492 rather than generic bundled rates.
Administrative Framework
Operational Requirements
minimum time
70 minutes of clinical staff time in the INITIAL month.
team roles
Must have: 1) Billing Provider (PCP); 2) Behavioral Health Care Manager; 3) Psychiatric Consultant.
tools
Must use a systematic 'registry' to track patient progress.
caseload review
Must include weekly caseload review with the psychiatric consultant.
Compliance Checklist
Audit Defense
consultant invisibility
Audit failure occurs if the consultant's name or their specific feedback is not present in the record.
registry proof
Must be able to produce the registry report if audited.
2026 Update
Initial CoCM (99492) is 70 minutes; subsequent months (99493) are only 60 minutes. Threshold differences are a common audit pitfall.
Common Clinical Scenarios
Target Specialties & Utilization
Typical Clinical Indications (ICD-10)
Frequently Asked Questions
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