CPT 99493: Psychiatric Collaborative Care — Subsequent 60 Minutes.
CPT 99493 covers each subsequent calendar month of Psychiatric Collaborative Care Management (CoCM) following the initial month (which is billed as 99492). The code reimburses 60 or more minutes of behavioral health care manager time per month for ongoing patient engagement, repeated validated screening, treatment adjustment, and continued participation in the weekly psychiatric registry review. Billing 99493 typically continues monthly until the patient achieves remission, transitions out of CoCM, or the BHCM determines the patient no longer benefits from the model.
Quick Answer
What is CPT 99493?
CPT 99493 is the Medicare billing code for each subsequent calendar month of Psychiatric Collaborative Care Management (CoCM) following the initial 99492 month. It reimburses approximately $130 per month for 60+ minutes of behavioral health care manager time, including continued patient engagement, validated screening reassessment, care plan updates, and participation in the weekly psychiatric registry review. CoCM episodes typically run 6 to 12 months. 99493 cannot be billed in the same month as general BHI (99484) but can be stacked with RPM and CCM.
Documentation
Documentation requirements.
Continued patient consent on file from initial 99492 month
Updated validated screening scores (PHQ-9, GAD-7) for the month with comparison to baseline and prior months
Care plan progress notes — what changed, what's working, what's being adjusted
Documentation of continued psychiatric consultant participation (typically weekly registry review)
Time log totaling 60+ minutes in the calendar month
Care coordination notes with the primary care provider and any other involved providers
Billing Workflow
How to bill 99493, step by step.
The calendar-month workflow a billing team actually runs — from qualifying the month to the increment math at month close.
Confirm the episode is continuous
99493 covers months that follow a 99492 initial month within the same CoCM episode. If the prior episode formally concluded — a remission discharge, for example — a later re-engagement is a new episode that restarts at 99492, not a subsequent month.
Re-administer the instruments
Validated tools (PHQ-9, GAD-7) are re-scored at the planned cadence — typically monthly — so the record shows treatment response over time, not a single baseline score from month one.
Log BHCM time toward 60 minutes
The subsequent-month threshold is 60 minutes of behavioral health care manager time, not the 70 required in the initial month. Keep the same per-activity log format the initial month used.
Keep the registry review going
The weekly psychiatric caseload review continues in every billed month, with each consultation documented. CoCM structure that lapses while billing continues is the pattern reviewers look for.
Do the month-close math
60 or more BHCM minutes: bill 99493. Each full additional 30 minutes: add one 99494 unit. Under 60 minutes: the month is not billable as 99493 — there is no partial credit.
Scenarios
Common billing scenarios.
Month 2 of CoCM for depression with partial response
BillableA patient billed as 99492 in month 1 (PHQ-9 = 16 at baseline). In month 2, the BHCM spends 65 minutes administering a follow-up PHQ-9 (now 11 — partial response), reviewing the case at psychiatric registry, adjusting the care plan to add behavioral activation goals, and conducting two patient outreach calls. Bill 99493.
Subsequent month plus additional time for complex case
BillableA patient with major depression and comorbid alcohol use disorder requires 95 minutes of BHCM time in month 4 due to a substance use relapse needing care coordination with an outpatient SUD program. Bill 99493 for the first 60 minutes and 99494 for the additional 35 minutes.
BHCM time fell short of 60 minutes
Not BillableIn month 3 of CoCM, the BHCM only spent 45 minutes on the patient due to a missed appointment and limited outreach. The 60-minute threshold for 99493 is not met. The practice cannot bill 99493 for this month; if the case warrants ongoing CoCM, expect to meet the threshold in following months.
Subsequent month after pause in CoCM
Not BillableA patient was in CoCM for 4 months, paused for 3 months due to remission, and returned with relapse symptoms. The practice debates whether to bill 99492 (initial) or 99493 (subsequent). Because the prior CoCM episode formally concluded, this re-engagement is a new episode and should bill 99492 for the first month, then 99493 going forward.
Audit & Compliance
Audit rules & denial defense for 99493.
What a payer reviewer checks on a records request, the failure that triggers each denial, and the documentation that survives it.
Threshold substantiation at 60 minutes
Denial risk
Subsequent-month claims whose log re-adds to 45-55 minutes fail the threshold; the month is denied rather than prorated.
What survives review
A BHCM time log that recomputes past 60 minutes with per-activity descriptions.
Ongoing measurement, not a one-time screen
Denial risk
A baseline PHQ-9 from the initial month with no follow-up scores undercuts the treat-to-target model every later claim relies on.
What survives review
Repeat instrument scores at the cadence the care plan promised, showing response tracking month over month.
Episode continuity
Denial risk
Billing 99493 after an episode formally concluded misclassifies what is actually a new episode — the re-engagement month should have restarted at 99492.
What survives review
Episode start and close dates in the record, so initial versus subsequent months are unambiguous on review.
The psychiatric review persists
Denial risk
Registry-review documentation that stops after the initial month suggests the CoCM structure lapsed while claims kept going out.
What survives review
Dated registry notes for every billed month with the consulting psychiatrist identified.
FAQ
Common questions about CPT 99493.
What is CPT 99493?
CPT 99493 is the Medicare billing code for each subsequent calendar month of Psychiatric Collaborative Care Management (CoCM) after the initial 99492 month. It covers 60 or more minutes of behavioral health care manager time per month for ongoing patient management, screening reassessment, and psychiatric registry review. It reimburses approximately $130 per month under the 2026 Medicare fee schedule.
How much does CPT 99493 reimburse in 2026?
CPT 99493 reimburses approximately $130 per patient per subsequent month under the 2026 Medicare Physician Fee Schedule. Over a typical 6-month CoCM episode, a patient might generate $163 (99492 initial month) + 5 × $130 (99493 subsequent months) = $813 in CoCM revenue, plus any 99494 add-ons for additional time.
What is the difference between 99492 and 99493?
99492 is billed for the initial calendar month of a CoCM episode and requires 70+ minutes of behavioral health care manager time (more, because of intake and care-plan creation overhead). 99493 is billed for each subsequent month and requires 60+ minutes. The activities are similar — patient outreach, screening, care plan updates, psychiatric registry review — but the initial month covers the additional setup work and therefore reimburses more.
How long can 99493 be billed for a single patient?
There is no hard CMS limit on the number of consecutive months 99493 can be billed, but CoCM is intended as a time-limited intervention. Most evidence-based CoCM programs run 6 to 12 months per episode, after which the patient either achieves remission, transitions to standalone behavioral health care, or is reassessed. If a patient continues to need monthly intensive behavioral health management indefinitely, the practice should consider whether a higher level of care is appropriate.
What if BHCM time falls short of 60 minutes in a subsequent month?
If the 60-minute threshold is not met in a given subsequent month, 99493 cannot be billed for that month. The patient remains in the CoCM episode — the next month can resume billing if the threshold is again met. Practices should document the reason the time was short (missed appointment, holiday week, patient declined outreach) and adjust outreach in subsequent months to maintain compliance.
Can 99493 be billed alongside RPM or CCM?
Yes. 99493 can be billed in the same month as RPM (99454/99457) and CCM (99490) for the same patient, provided the time and clinical activities are distinct. CoCM time must specifically focus on behavioral health management. 99493 cannot be billed in the same month as 99484 (general BHI) for the same patient — the two behavioral health pathways are mutually exclusive within a month.
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
BHI Care Management (20 Min)
$53.00 • Once per calendar month
CoCM Initial Month (70 Min)
$163.00 • Once per CoCM episode — the initial month only (subsequent months bill 99493)
CoCM 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.