• Psychiatric Collaborative Care Management Services 99492, 99493, 99494
• Care Management for Behavioral Health 99484
• G0323 Care management by a clinical psychologist, clinical social worker, mental health counselor or marriage and family therapist
• PCCM quick reference sheet

Psychiatric Collaborative Care Management Services 99492, 99493, 99494, 99484 G2214, G0323

Definition

Services provided under the direction of a treating physician/NPP 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 care of a behavioral health manager have signs or symptoms of their condition, may have a newly diagnosed condition, and may also need help 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]