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March 25, 2023

Psychiatric Collaborative Care Management Services

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  • Psychiatric Collaborative Care Management Services 99492, 99493, 99494
  • Care Management for Behavioral Health 99484
  • PCCM quick reference sheet

Psychiatric Collaborative Care Management Services 99492, 99493, 99494

Definition

Services provided under the direction of a treating physician/NP/PA for work performed by a behavioral health care manager in consultation with a psychiatric consultant. A single, lump sum monthly payment to the primary care practice.

Explanation

These codes describe face-to-face and non-face-to-face services for patients with behavioral health conditions directed by the patient’s PCP, provided by a behavioral health manager and in consultation with a psychiatric consultant. The psychiatric consultant is an individual able to prescribe the full range of psychiatric medications.

This recognizes the work and time of practitioners and staff in caring for patients with behavioral conditions outside of an E/M visit. These services require an initiating visit by a physician or non-physician practitioner (NPP) who can perform E/M services as part of their scope of practice. CPT® uses the term qualified health care professional.

Patients directed to the behavioral health manager have signs or symptoms of their condition or may have a newly diagnosed condition, and may also need help in engaging in treatment or have not responded to standard treatment.

“These services are provided when a patient requires a behavioral health care assessment; establishing, implementing, revising, or monitoring a care plan; and provision of assessment; establishing, implementing, revising, or monitoring a care plan; and provision of brief interventions.”[1]

[1] Current Procedural Terminology 2023, Professional ed.

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Last revised January 11, 2023 - Betsy Nicoletti
Tags: care management

CPT®️️ is a registered trademark of the American Medical Association. Copyright American Medical Association. All rights reserved.

2023 E/M reference sheets

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Effective January 1, 2023, the AMA has revised the definitions and guidelines for hospital and other E/M services, including ED visits, nursing facility services, home services, and domiciliary care codes. Also, coding for prolonged care services gets another overhaul with revised codes and guidelines. Watch this webinar about all these changes.

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Our mission is to provide up-to-date, simplified, citation driven resources that empower our members to gain confidence and authority in their coding role.

In 1988, CodingIntel.com founder Betsy Nicoletti started a Medical Services Organization for a rural hospital, supporting physician practice. She has been a self-employed consultant since 1998. She estimates that in the last 20 years her audience members number over 28,400 at in person events and webinars. She has had 2,500 meetings with clinical providers and reviewed over 43,000 medical notes. She knows what questions need answers and developed this resource to answer those questions. For more about Betsy visit www.betsynicoletti.com.

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