CPT 99492 is used to bill the first 70 minutes of Collaborative Care Model (CoCM) services in the initial month. It involves a behavioral health care manager, a psychiatric consultant, and a billing provider.

Who can bill CPT 99492?

CPT 99492 can be billed by a physician, nurse practitioner, or physician assistant who supervises a behavioral health care manager and collaborates with a psychiatric consultant.

Can CPT 99492 be billed more than once?

No. CPT 99492 is a first-month only code and may only be billed once per patient. For ongoing CoCM services, use CPT 99493.

What is the time requirement for CPT 99492?

At least 36 minutes of collaborative psychiatric care must be documented in the first calendar month. If time exceeds 70 minutes, add CPT 99494.

What documentation is required for CPT 99492?

Documentation must include a behavioral health diagnosis, a care plan, participation by a psychiatric consultant, a behavioral health care manager, time logs, and oversight by the billing provider.

CPT 99492
Description, Billing Rules, and Use Cases

CPT 99492 is used to bill for the first month of Collaborative Care Model (CoCM) services for patients receiving integrated behavioral health care.

This code covers the first 70 minutes of team-based psychiatric care delivered by a behavioral health care manager in coordination with a psychiatric consultant and the billing physician or qualified healthcare professional (QHP).

CPT 99492 may be billed only once per patient, and applies only to the initial calendar month of CoCM services. If time exceeds 70 minutes, CPT 99494 may be added to report each additional 30-minute block.

What is CPT Code 99492?

CPT 99492 is the introductory billing code for the Collaborative Care Model (CoCM) — a psychiatric care integration model that relies on structured coordination between a behavioral health care manager, a psychiatric consultant, and the patient’s primary care provider (PCP) or other billing QHP.

Use CPT 99492 when:

The patient has a behavioral health condition such as:

Major depressive disorder (MDD)

Generalized anxiety disorder

PTSD or other trauma-related conditions

Substance use disorder

A psychiatric consultant is engaged to provide treatment recommendations

A behavioral health care manager works under general supervision to:

Provide care coordination and brief interventions

Track clinical outcomes using validated tools (e.g., PHQ-9, GAD-7)

Facilitate communication between all members of the care team

At least 36 minutes of CoCM activity is completed in the first calendar month

Services are:

Non-face-to-face

Delivered by a coordinated team under the billing provider’s supervision

CPT 99492 may only be billed once per patient, and only for the initial CoCM month. Add CPT 99494 if total time exceeds 70 minutes. In later months, use CPT 99493.

CPT 99492 Billing Requirements and Eligibility

CPT 99492 is used to report the first 70 minutes of Collaborative Care Model (CoCM) services in the initial month of psychiatric integration. This model requires a structured partnership between a behavioral health care manager, a psychiatric consultant, and the patient’s primary care provider or billing QHP.

To bill CPT 99492, the following conditions must be met:

Patient Eligibility Criteria

The patient has one or more diagnosed behavioral health conditions, such as:
- Major depressive disorder (MDD)
- Generalized anxiety disorder (GAD)
- PTSD or trauma-related disorder
- Substance use disorder
- Other ICD-10 coded behavioral health diagnoses
The condition is actively being treated and integrated into the primary care plan

Care Plan Requirements

A structured behavioral health care plan must be:
- Developed or reviewed during the billing month
- Based on validated assessments (e.g., PHQ-9, GAD-7)
- Maintained and updated collaboratively by the BHCM, psychiatric consultant, and billing provider
The plan should include:
- Behavioral health goals
- Planned interventions
- Clinical outcome measures
- Follow-up strategy and documentation of progress

Service and Time Requirements

At least 36 minutes of CoCM activity must be completed in the first calendar month
Activities must include:
- Behavioral health assessment and symptom tracking (e.g., PHQ-9)
- Patient engagement and follow-up
- Coordination with the psychiatric consultant and primary care team
- Treatment plan development and documentation
Services must be:
- Non-face-to-face
- Performed by the CoCM team under general supervision
- Distinct from other care management time billed under CCM, PCM, or TCM codes

Billing Limitations

CPT 99492 can be billed only once per patient, and only in the first month of CoCM services
If CoCM services continue in subsequent months, use CPT 99493
If time exceeds 70 minutes in the first month, add CPT 99494 for each additional 30-minute block

CPT 99492 Billing Documentation Checklist

To compliantly bill CPT 99492, the following must be clearly documented in the patient record:

A behavioral health diagnosis supported by ICD-10 coding
- Examples include MDD, GAD, PTSD, or substance use disorder
- Diagnosis must be active and the focus of care during the billing month

A behavioral health care plan that was:
- Developed or updated during the billing period
- Based on a validated screening tool (e.g., PHQ-9, GAD-7)
- Integrated into the patient’s overall care plan
- Documented with:
  - Behavioral goals
  - Planned interventions
  - Outcome tracking and follow-up strategy

A clearly defined CoCM team, including:
- Billing provider (physician, NP, or PA)
- Behavioral health care manager (BHCM)
- Psychiatric consultant (e.g., psychiatrist or clinical psychologist)

A minimum of 36 minutes of CoCM services delivered in the calendar month
- Services must be:
  - Non-face-to-face
  - Performed by the CoCM team
  - Directed by the billing provider
  - Logged with start/stop or cumulative time totals
- Activities may include:
  - Reviewing structured assessments (e.g., PHQ-9)
  - Tracking symptoms
  - BHCM follow-up with the patient
  - Team consultation and treatment adjustments

Psychiatric consultant review and treatment recommendations
- Must be documented in the chart or via care team communication
- Consultant does not see the patient directly, but provides clinical oversight

An attestation or documentation note from the billing provider, confirming:
- Review of BHCM activities and documentation
- Coordination with the psychiatric consultant
- Oversight of the full CoCM process

CPT 99492 Time Thresholds and Code Combinations

CPT 99492 is used to report the first 70 minutes of Collaborative Care Model (CoCM) services delivered in the initial calendar month of behavioral health integration. Services must be provided by a team of licensed professionals including a behavioral health care manager, a psychiatric consultant, and a billing physician or QHP.

Use the chart below to determine how to report time spent:

Time-based billing table for CPT 99492 showing thresholds for collaborative psychiatric care management in the first month, with CPT 99494 added when time exceeds 70 minutes.

Important to Note:

CPT 99492 may be billed only once per patient, and only during the first month of CoCM services. If CoCM continues in subsequent months, use CPT 99493.

If time exceeds 70 minutes in the first month, you may bill CPT 99494 in addition to 99492, once for each additional 30-minute block of care.

All time must be:

Non-face-to-face
Collaborative (not standalone psychiatric treatment)
Delivered by the CoCM team under the supervision of the billing provider
Distinct from other billed time under CCM, PCM, TCM, or 99484

When to Use CPT 99492:
Common Scenarios and Use Cases

CPT 99492 should be used when a behavioral health care manager, under the supervision of a billing provider, delivers at least 36 minutes of non-face-to-face psychiatric collaborative care management in the first calendar month of CoCM services. A psychiatric consultant must also be engaged to support diagnosis and treatment planning.

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

Depression Diagnosis and Initial Treatment Coordination
A BHCM:
- Conducts a PHQ-9 and screens for suicidality
- Coordinates with a psychiatric consultant to confirm diagnosis and treatment strategy
- Reviews recommendations with the PCP and updates the shared care plan
- Follows up with the patient weekly via phone
  Total time: 42 minutes
  Billing: 99492

Complex Anxiety With Substance Use In a New CoCM Case
A BHCM:
- Tracks the patient’s GAD-7 and substance use log
- Collaborates with the psychiatric consultant for dual-diagnosis management
- Coordinates referral to outpatient therapy
- Engages the patient for brief weekly check-ins and updates the PCP
  Total time: 78 minutes
  Billing: 99492 + 99494

PTSD With Medication Resistance and Multiple Care Adjustments
A BHCM:
- Conducts structured interviews and completes clinical outcome tracking
- Engages the psychiatrist to reevaluate the care plan mid-month
- Provides frequent follow-up and updates the PCP after each psychiatric consult
  Total time: 102 minutes
  Billing: 99492 + 99494 x2

Common CPT 99492 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 99492 Without a Psychiatric Consultant
CPT 99492 requires documented involvement of a psychiatric consultant, such as a psychiatrist or clinical psychologist. If no consultant is involved in diagnosis or treatment planning, the service does not meet CoCM criteria.
❌ Using 99492 for Staff-Only Behavioral Health Services
This code is not for stand-alone clinical staff time. A behavioral health care manager, billing provider, and psychiatric consultant must all be documented as part of the collaborative team.
❌ Billing for Fewer Than 36 Minutes
- You must document at least 36 minutes of CoCM services in the first month. If time falls short, the code is not billable—even if a care plan is created.
❌ Billing 99492 More Than Once Per Patient
- CPT 99492 is a first-month only code. It may be billed only once per patient. For subsequent months, use CPT 99493, with 99494 for additional time blocks.
❌ Double Billing With Other Care Management Codes
- You cannot bill 99492 in the same month as:
  - 99490–99491 (CCM)
  - 99484 (general BHI)
  - 99424–99427 (PCM)
  - 99487–99489 (complex CCM)
  - 99495–99496 (TCM)
- Each care management model must be billed independently, with no overlapping time.
❌ Insufficient Documentation of Care Team Activity
You must record:
- The behavioral health diagnosis and validated screening results
- All time logs across the team, including BHCM, consultant, and provider coordination
- Psychiatric consultant input and care plan recommendations
- Oversight by the billing provider and plan review documentation

CPT 99492 Description, Billing Rules, and Use Cases