CPT 99484 is a billing code for Behavioral Health Integration services delivered by clinical staff under a physician's supervision. It covers 20 or more minutes per calendar month.

Who can bill CPT 99484?

CPT 99484 is billed by a physician or qualified healthcare provider who oversees clinical staff delivering behavioral health integration services.

How many times can CPT 99484 be billed in a month?

CPT 99484 may only be billed once per patient per calendar month, regardless of how much time is spent beyond the 20-minute threshold.

Can CPT 99484 be billed with CCM or CoCM codes?

No. CPT 99484 cannot be billed in the same month as codes for chronic care management (99490–99491), complex CCM (99487–99489), or psychiatric CoCM (99492–99494).

What documentation is required for CPT 99484?

You must document a behavioral health diagnosis, at least 20 minutes of clinical staff time, a behavioral care plan, and the supervising provider's oversight.

CPT 99484
Description, Billing Rules, and Use Cases

CPT 99484 is used to bill for Behavioral Health Integration (BHI) services delivered by clinical staff under the supervision of a physician or qualified healthcare professional.

This code applies when a care team spends at least 20 minutes per month managing a patient’s behavioral health needs as part of their overall care plan.

CPT 99484 may only be billed once per calendar month.

What is CPT Code 99484?

CPT 99484 is a time-based billing code that allows providers to report non-face-to-face care management services delivered by clinical staff to support patients with behavioral health conditions. These services must be coordinated and reviewed by a physician or qualified healthcare professional (QHP), but the time itself is accumulated by staff such as nurses, MAs, or care managers.

To qualify for 99484:

The patient must have one or more diagnosed behavioral health conditions, such as depression, anxiety, substance use disorder, or PTSD

A behavioral health care plan must be created, revised, or monitored during the billing month

At least 20 minutes of care management time must be delivered by clinical staff

Services must be non-face-to-face and may include:

Patient follow-up

Coordination with mental health providers

Tracking treatment response using validated tools

Referral support and adherence coaching

99484 may be billed only once per month, and does not increase with additional time. If your care model includes psychiatric consultation, consider the CoCM codes 99492–99494 instead.

CPT 99484 Billing Requirements and Eligibility

CPT 99484 is used to report Behavioral Health Integration (BHI) services provided by clinical staff under the general supervision of a physician or qualified healthcare professional (QHP).

These services support the ongoing care coordination and management of patients with one or more diagnosed behavioral health conditions.

Patient Eligibility Criteria

The patient has at least one behavioral health diagnosis, such as:
- Major Depressive Disorder (MDD)
- Generalized anxiety disorder
- Post-traumatic Stress Disorder (PTSD)
- Substance use disorder
- Attention Deficit Hyperactivity Disorder (ADHD)
Behavioral health is a central focus of the care provided that month

Care Plan Requirements

A behavioral health care plan must be:
- Established, implemented, revised, or monitored during the billing period
- Integrated into the patient’s overall care coordination plan
- Documented in the medical record with goals, interventions, and tracking methods
Validated tools such as PHQ-9, GAD-7, or other structured assessments are often used

Provider Requirements

The billing provider must be a physician, NP, or PA overseeing the plan
Clinical staff may perform the services, but they must operate under general supervision
The billing provider must review staff documentation and ensure care plan continuity

Service Requirements

At least 20 minutes of non-face-to-face care management must be delivered by clinical staff during the month

Activities may include:
- Patient outreach and symptom monitoring
- Education or adherence coaching
- Coordination with external behavioral health providers
- Documenting changes in status and revising the care plan as needed
Services must be:
- Non-face-to-face
- Focused on behavioral health integration
- Distinct from other time-based services (e.g., CCM, CoCM, PCM, TCM)

Note: CPT 99484 may only be billed once per month, regardless of how much time is spent beyond the 20-minute minimum.

CPT 99484 Billing Documentation Checklist

To support compliant billing for CPT 99484, the following elements must be documented in the patient’s record:

A behavioral health diagnosis that is clearly coded in the chart, such as:
- Major depressive disorder (MDD)
- Generalized anxiety disorder
- PTSD
- Substance use disorder
- ADHD, dysthymia, or other recognized behavioral health conditions
A behavioral health care plan that was:
- Created, revised, or actively managed during the calendar month
- Documented in the EHR
- Focused on the diagnosed behavioral health condition(s)
- Shared with the patient or caregiver when appropriate
At least 20 minutes of non-face-to-face care management time delivered by clinical staff under provider supervision
- Include start/stop times or cumulative time tracking
- Clearly identify which activities were performed and by whom
A description of services such as:
- Monitoring behavioral health symptoms using structured tools (e.g., PHQ-9, GAD-7)
- Patient or caregiver communication
- Coordination with behavioral health specialists
- Education, adherence support, or follow-up
Confirmation that services were:
- Directed by a physician or QHP
- Delivered by staff under general supervision
- Non-overlapping with other time-based care management services, such as:
  - Chronic Care Management (99490, 99491)
  - Principal Care Management (99424–99427)
  - Collaborative Care Model codes (99492–99494)
  - Transitional Care (99495–99496)
Attestation or review note from the billing provider confirming oversight of care activities and review of staff documentation

CPT 99484 Time Thresholds and Code Combinations

CPT 99484 is used to report non-face-to-face Behavioral Health Integration (BHI) services delivered by clinical staff under the supervision of a physician or qualified healthcare professional. A minimum of 20 minutes must be spent on care management in a calendar month to bill this code.

Important: CPT 99484 may only be billed once per patient per month, regardless of how much time is spent beyond the 20-minute threshold.

Use the table below to determine eligibility for billing:

Time-based billing table for CPT 99484. Shows when to report behavioral health integration services delivered by clinical staff once 20 minutes are reached.

Important to Note:

CPT 99484 does not support multiple units or billing tiers. Whether clinical staff spend 21 minutes or 90 minutes, only one unit may be billed per calendar month.

This code cannot be reported in the same month as:

Collaborative Care Model (CoCM) codes 99492–99494
Chronic Care Management (99490–99491)
Principal Care Management (99424–99427)
Complex CCM (99487–99489) or Transitional Care codes (99495–99496)

All billed time must be distinct, focused on behavioral health, and documented under a physician-directed care plan.

When to Use CPT 99484:
Common Scenarios and Use Cases

CPT 99484 should be used when clinical staff, under the supervision of a physician or qualified healthcare professional, spend at least 20 minutes in a calendar month managing a patient’s behavioral health needs as part of an integrated care plan. These services must be non-face-to-face, and the code can be billed once per month per patient, regardless of how much time is spent beyond the 20-minute threshold.

Here are examples of how CPT 99484 is used in practice:

Depression Monitoring and Patient Support
A nurse care coordinator:
- Administers a PHQ-9 depression screening
- Reviews symptom tracking logs with the patient
- Communicates with the supervising physician to adjust the care plan
  Total time: 28 minutes
  Billing: 99484

Follow-Up Coordination for Anxiety Disorder
Clinical staff under physician supervision:
- Conduct a check-in call to assess medication side effects
- Coordinate with an external behavioral health provider
- Document changes in mood using the GAD-7 scale
  Total time: 22 minutes
  Billing: 99484

Post-Hospitalization Care for PTSD
A care manager:
- Coordinates community support services
- Tracks treatment adherence and therapy attendance
- Updates the behavioral health care plan with input from the supervising NP
  Total time: 75 minutes
  Billing: 99484 (One Unit Only)

Common CPT 99484 Billing Mistakes
(and How to Avoid Them)

Billing CPT 99484 may seem straightforward, but it’s subject to strict CMS guidance. Watch for these common issues that can lead to denials or audits:

❌ Billing CPT 99484 Without 20 Minutes of Staff Time
You must document at least 20 minutes of non-face-to-face care management services delivered by clinical staff. Anything less is not billable under this code.
❌ Counting Provider Time Toward the Threshold
CPT 99484 is based on clinical staff time, not time spent by the billing provider. If the physician or QHP delivers the service directly, it may need to be billed under another applicable code.
❌ Double Billing With CoCM or CCM Codes
- You may not bill 99484 in the same month as:
  - 99492–99494 (Collaborative Care Model)
  - 99490–99491 (Chronic Care Management)
  - 99424–99427 (Principal Care Management)
  - 99487–99489 (Complex CCM)
- Each code family represents a separate care management pathway. Time and services may not be duplicated across codes.
❌ Billing More Than One Unit Per Month
- CPT 99484 is limited to one unit per calendar month per patient. Even if your team logs 40, 80, or 120 minutes, only one instance of 99484 may be billed.
❌ Incomplete or Nonspecific Documentation
- You must document:
  - The exact amount of clinical staff time spent on behavioral health integration
  - The diagnosed behavioral health condition(s)
  - That a behavioral health care plan was created or updated
  - Specific services performed (e.g., symptom tracking, coordination, patient outreach)
  - The supervising provider’s oversight and care continuity

CPT 99484 Description, Billing Rules, and Use Cases