Reimbursement
$135.94
Threshold
60m
2026 Status
Active
What is CPT Code 99493?
CPT 99493 is defined as: Subsequent psychiatric collaborative care management, first 60 minutes in a subsequent 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
2.05
Physician Effort
PE (Non-Fac)
1.93
Practice Expense
Malpractice
0.09
Risk Factor
Total RVU
4.07
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).
revenue stability
Provides high reimbursement ($115.23) for ongoing specialized mental health oversight in primary care settings.
Administrative Framework
Operational Requirements
minimum time
60 minutes of clinical staff time in SUBSEQUENT months.
team roles
Must maintain: 1) Billing Provider; 2) Behavioral Health Care Manager; 3) Psychiatric Consultant.
caseload review
Weekly caseload review session documented.
billing unit
Once per calendar month.
Compliance Checklist
Audit Defense
time reduction
Common audit error is using the 70-minute threshold for subsequent months; 99493 only requires 60 minutes.
manager log
Ensure logs show active management, not just passive registry maintenance.
2026 Update
If the patient recovers, CoCM should transition back to General BHI (99484) or standard primary care.
Common Clinical Scenarios
Target Specialties & Utilization
Typical Clinical Indications (ICD-10)
Frequently Asked Questions
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