CPT 99494: Psychiatric Collaborative Care — Additional 30 Minutes.
CPT 99494 is the add-on code for each additional 30 minutes of behavioral health care manager time in a calendar month, beyond the base time required by 99492 (initial month, 70 minutes) or 99493 (subsequent months, 60 minutes). The code allows practices to be reimbursed for the real time required to manage complex behavioral health cases — substance use comorbidity, trauma, treatment-resistant depression — where 60 or 70 minutes is insufficient. 99494 can only be billed in combination with 99492 or 99493 in the same month for the same patient.
Quick Answer
What is CPT 99494?
CPT 99494 is the Medicare billing code for each additional 30 minutes of behavioral health care manager time in a calendar month, billed as an add-on to 99492 (initial CoCM month) or 99493 (subsequent CoCM month). It reimburses approximately $66 per 30-minute increment under the 2026 Medicare fee schedule. Each unit requires a full 30 minutes; partial increments do not count. 99494 cannot be billed standalone — it always pairs with 99492 or 99493 for the same patient in the same month.
Documentation
Documentation requirements.
Time log clearly distinguishing base 99492/99493 time from each additional 30-minute increment claimed
Clinical justification for the additional time — comorbidity, crisis response, complex care coordination
Activity descriptions for the additional time block(s)
Confirmation that 99492 or 99493 was also billed in the same month for the same patient
Patient consent and care plan documentation per the underlying 99492/99493 requirements
Scenarios
Common billing scenarios.
Initial month with 100 minutes of BHCM time
BillableA patient with major depression and recent suicidal ideation requires intensive intake — the BHCM spends 100 minutes in the initial month on safety planning, psychiatric registry review, and patient outreach. Bill 99492 for the first 70 minutes and 99494 for the additional 30-minute increment (90-100 minutes still falls in one 30-min add-on).
Subsequent month with 125 minutes for complex case
BillableA patient with major depression and alcohol use disorder needs extensive care coordination with an outpatient SUD program in month 5 of CoCM. BHCM logs 125 minutes. Bill 99493 (first 60 minutes) and 2 × 99494 (additional 60 minutes in two 30-minute increments).
99494 billed without 99492 or 99493 in the same month
Not BillableA practice attempts to bill 99494 standalone for a patient whose primary CoCM time fell short of the 99493 60-minute threshold. 99494 is an add-on code that requires 99492 or 99493 to be billed in the same month for the same patient — it cannot be billed alone.
Additional time logged but not 30 full minutes
Not BillableBHCM spends 78 minutes in a subsequent month — 60 for the base 99493 plus 18 extra minutes. The additional time is short of the 30-minute increment required for 99494. Bill 99493 only; the 18 additional minutes are not separately reimbursable.
FAQ
Common questions about CPT 99494.
What is CPT 99494?
CPT 99494 is the Medicare billing code for each additional 30 minutes of behavioral health care manager time in a calendar month, beyond the base time required by 99492 (70 minutes, initial CoCM month) or 99493 (60 minutes, subsequent CoCM month). It is an add-on code — it cannot be billed alone and requires 99492 or 99493 to be billed in the same month for the same patient. It reimburses approximately $66 per 30-minute increment under the 2026 Medicare fee schedule.
How much does CPT 99494 reimburse in 2026?
CPT 99494 reimburses approximately $66 per 30-minute increment under the 2026 Medicare Physician Fee Schedule. Each 99494 unit added to a 99492 or 99493 base meaningfully increases per-patient revenue — a 95-minute subsequent month (99493 + one 99494) generates approximately $196 versus $130 for the base 99493 alone.
Can 99494 be billed multiple times in one month?
Yes. There is no per-month cap on 99494 units, provided each 30-minute increment is fully documented and clinically justified. A patient requiring 150 minutes of BHCM time in a subsequent month could be billed as 99493 (60 minutes) + 3 × 99494 (90 additional minutes in three 30-minute increments). The full time must be logged with activity descriptions.
Does 99494 require a full 30 minutes, or partial increments?
99494 requires a full 30 minutes per unit. Partial increments do not count — for example, 78 minutes total in a subsequent month bills 99493 only (60 minutes) and the 18 additional minutes are not separately reimbursable. Once an additional 30-minute block is fully reached (90 minutes total), one 99494 unit can be billed.
What clinical scenarios commonly justify 99494?
99494 is most commonly justified for: (1) comorbid substance use disorder requiring coordination with an external SUD program, (2) trauma-focused cases requiring extended safety planning, (3) treatment-resistant depression cases needing additional psychiatric consultation, (4) crisis weeks involving same-day outreach and follow-up, and (5) patients with multiple behavioral health diagnoses where care plan complexity exceeds typical CoCM scope. Documentation must explain why the additional time was clinically necessary.
Can 99494 be billed alongside 99484?
No. 99494 is an add-on to the CoCM model (99492/99493). 99484 is the general BHI code for practices not using the CoCM model. The CoCM model (99492/99493/99494) and general BHI (99484) are mutually exclusive within a calendar month for the same patient. If a practice is billing CoCM that month, all behavioral health time falls under 99492/99493/99494.
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 Subsequent Month (60 Min)
$130.00 • Monthly, in each month after the initial 99492 month
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.