CPT 99484: Behavioral Health Integration Care Management Billing Guide (2026).
CPT 99484 covers care management services for behavioral health conditions lasting 20 or more minutes of clinical staff time per calendar month. Services include behavioral health assessment, care planning, and ongoing management under the direction of a physician or qualified healthcare professional. This code supports primary care practices that integrate behavioral health screening and management — such as depression, anxiety, and substance use disorder — without requiring a formal Psychiatric Collaborative Care Model (CoCM).
Quick Answer
What is CPT 99484?
CPT 99484 is the Medicare billing code for Behavioral Health Integration (BHI), covering 20+ minutes of clinical staff time per month for managing behavioral health conditions in primary care. It reimburses approximately $53 per month under the 2026 CMS fee schedule. The code supports depression, anxiety, and substance use disorder management using validated screening tools like PHQ-9 and GAD-7. BHI can be stacked with CCM and RPM for the same patient but cannot be billed alongside CoCM codes (99492-99494) in the same month.
Documentation
Documentation requirements.
Identified behavioral health condition(s) being managed with ICD-10 diagnosis code
Behavioral health care plan with measurable treatment goals and target outcomes
Time log documenting 20+ minutes of behavioral health care management activities
Validated assessment tool results at baseline and follow-up (e.g., PHQ-9 for depression, GAD-7 for anxiety, AUDIT-C for alcohol use)
Documentation of care coordination with behavioral health specialists when applicable
Patient progress notes with treatment response and care plan adjustments
Scenarios
Common billing scenarios.
Primary care manages depression with PHQ-9 monitoring
BillableA care coordinator spends 25 minutes during the month administering a PHQ-9 follow-up assessment, reviewing the patient's antidepressant response with the physician, adjusting the care plan, and calling the patient to discuss coping strategies. The behavioral health focus and 20-minute threshold are met.
General care coordination without behavioral health focus
Not BillableA nurse spends 20 minutes coordinating care for a patient with diabetes and hypertension, including medication management calls. Even though the patient also has anxiety, the care coordination activities were focused on medical conditions, not behavioral health. Bill CCM (99490), not BHI (99484).
BHI stacked with CCM and RPM for the same patient
BillableA patient with CHF, diabetes (CCM), hypertension monitoring (RPM), and major depression (BHI) receives all three services in the same month. Each service has separate time documentation and distinct clinical activities. All three codes can be billed concurrently.
BHI billed in same month as CoCM codes (99492-99494)
Not BillableA practice bills both 99484 (general BHI) and 99492 (Psychiatric Collaborative Care, initial month) for the same patient. These codes are mutually exclusive — use either general BHI or the CoCM model, not both in the same month.
FAQ
Common questions about CPT 99484.
What is CPT 99484?
CPT 99484 is the Medicare billing code for Behavioral Health Integration (BHI), covering 20 or more minutes of clinical staff time per calendar month for managing behavioral health conditions in primary care settings. It reimburses approximately $53 per month under the 2026 Medicare fee schedule and supports management of depression, anxiety, substance use disorders, and other behavioral health conditions.
How much does CPT 99484 reimburse in 2026?
CPT 99484 reimburses approximately $53 per patient per month under the 2026 Medicare Physician Fee Schedule. While the per-patient revenue is modest compared to RPM or CCM, BHI can be stacked with those programs for the same patient, adding incremental revenue for behavioral health management that is already being provided.
What is the difference between BHI (99484) and CoCM (99492-99494)?
BHI (99484) is a general behavioral health care management code for any practice providing structured behavioral health services. CoCM codes (99492-99494) require a formal Psychiatric Collaborative Care Model with a designated behavioral health care manager and a consulting psychiatrist. CoCM reimburses more (99492 at ~$163 initial month) but requires more infrastructure. Practices without a consulting psychiatrist typically bill 99484.
What screening tools are required for 99484?
While CMS does not mandate specific tools, industry standards and compliance best practices require validated assessment instruments. The most commonly used tools are: PHQ-9 for depression, GAD-7 for anxiety, AUDIT-C for alcohol use, and DAST-10 for drug use. Assessments should be administered at baseline and at regular intervals to demonstrate treatment response and medical necessity.
Can BHI be billed alongside CCM and RPM?
Yes, BHI (99484) can be billed concurrently with both CCM (99490) and RPM (99454/99457) for the same patient in the same month. The key requirement is that time and activities must be distinct — BHI time must focus specifically on behavioral health management, not the medical conditions covered by CCM or RPM. A patient receiving all three can generate over $165 per month.
Who can provide the clinical services billed under 99484?
BHI services can be provided by clinical staff with appropriate behavioral health training, including licensed clinical social workers (LCSWs), psychologists, registered nurses, and other qualified behavioral health professionals. Services are provided under the direction of the billing physician or qualified healthcare professional, who establishes the care plan and oversees treatment.
Related Codes
Other CPT codes.
CCM Initial 20 Minutes
$62.00 • Once per calendar month
RPM Device Supply (16+ Days)
$52.11 • Monthly (per 30-day period)
RPM Clinical Review (First 20 Min)
$51.77 • Once per calendar month
RPM Initial Setup (One-Time)
$21.71 • One-time per episode of care
RPM Clinical Review (Additional 20 Min)
$41.42 • Monthly (per calendar month, add-on to 99457)
Complex CCM Initial 30 Minutes
$86.00 • Once per calendar month
PCM Physician Base (30 Min)
$88.00 • Once per calendar month
CoCM Initial Month (70 Min)
$163.00 • Once per CoCM episode — the initial month only (subsequent months bill 99493)
CoCM Subsequent Month (60 Min)
$130.00 • Monthly, in each month after the initial 99492 month
CoCM Add-On (Each 30 Min)
$66.00 • As needed, in 30-minute increments, in the same month as 99492 or 99493
Complex CCM Add-On (Each 30 Min)
$63.00 • Monthly, as needed, in addition to the base 99491
CCM Add-On (Each 20 Min)
$50.00 • Up to 2 units per calendar month, in addition to the base 99490
Sources & Compliance
CPT® notice. CPT is a registered trademark of the American Medical Association. CPT codes, descriptions, and other data only are copyright 2026 American Medical Association. All rights reserved. CPT is provided “as is” without warranty of any kind. The plain-language descriptions, billing scenarios, and FAQs on this page are CCN Health’s editorial summary and are not the official AMA long descriptors.
Reimbursement. Reimbursement figures shown are CCN Health estimates based on the CMS Medicare Physician Fee Schedule (CY 2026) using published RVU values and the 2026 conversion factor of $33.40. Final payment varies by locality (GPCI), facility status, and payer contract. Fee schedules, relative value units, and conversion factors are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use.
Sources. CMS Medicare Physician Fee Schedule, CY 2026 (cms.gov); AMA CPT 2026 Code Set (ama-assn.org).
Disclaimer. This page is informational and does not constitute billing, clinical, or legal advice. Verify all codes, modifiers, and reimbursement amounts against your contracted payer agreements and the official CMS publications before billing.