How to bill CoCM codes 99492, 99493, 99494 and G2214: 2026 checklist
Last updated · sources checked October 29, 2026
Quick answer
Bill CoCM once per calendar month from care-manager minutes: 99492 in the first month from 36 minutes, 99493 in later months from 31, 99494 for each further 30 minutes, or G2214 from 16 minutes. You need an initiating visit, documented consent, a registry, rating scales and a weekly psychiatric caseload consultation. Since January 2026, FQHCs and RHCs use these codes instead of G0512.
The four codes
| Code | When | Time block | Reportable from |
|---|---|---|---|
| 99492 | First month of Collaborative Care | First 70 minutes | 36 minutes |
| 99493 | Each later month | First 60 minutes | 31 minutes |
| 99494 | Add-on to 99492 or 99493 | Each additional 30 minutes | 86 minutes in a first month, 76 in a later month (16 into each extra block) |
| G2214 | First or later month (Medicare) | First 30 minutes | 16 minutes; not with 99492, 99493 or 99494 in the same month |
Count only behavioral health care manager minutes in the calendar month. CMS says “CPT time rules apply”: a time block is met once more than half of it has passed (the 50 percent plus one rule), which gives the thresholds above. For the full explanation of each code, see billing codes 99492, 99493, 99494 and G2214 explained.
Before the first month: required elements
- Initiating visit. The billing practitioner has seen the patient in a qualifying visit: an annual wellness visit, an initial preventive physical exam, a comprehensive E/M visit or a transitional care management visit.
- Consent documented. Verbal consent is enough for Medicare if it is in the record, including that cost sharing applies. A new consent is needed only if the billing practitioner changes.
- Patient entered in the registry. With baseline scores and the date of enrollment.
- Validated rating scales. For example the PHQ-9 and GAD-7 at the start, then used to monitor progress.
- Treatment plan. An initial assessment and individualized plan, reviewed by the psychiatric consultant.
Every month
- Log each care-manager contact and its minutes the same day.
- Weekly caseload consultation between the care manager and the psychiatric consultant, with the consultant's recommendations recorded and shared with the treating practitioner.
- Repeat the rating scales and record the scores in the registry.
- At month end, total the minutes per patient and match them to a code (try the calculator).
- Check no general BHI code (99484) is billed for the same patient in the same month: CMS does not allow both.
- G2214 is not billed in the same month as 99492, 99493 or 99494; 99494 is only billed with 99492 or 99493.
What changed in 2026
- FQHCs and RHCs bill Medicare with the standard codes. G0512 was discontinued as of January 1, 2026. FQHCs and RHCs now bill Medicare for Collaborative Care with 99492, 99493, 99494 and G2214, and the time rule applies (for example, 36 minutes for 99492) (AHRQ Academy, March 17, 2026).
- Medicaid is set state by state. North Carolina Medicaid, for example, end-dated G0512 on December 31, 2025, and lists 99492, 99493, 99494 and G2214, with up to four units of 99494 a month (NC Medicaid bulletin, December 30, 2025). Check your own state's manual.
- New add-on codes with Advanced Primary Care Management. From January 1, 2026, practices billing an APCM base code (G0556, G0557 or G0558) can report CoCM delivered the same month with add-on codes G0568 and G0569, which are not time-based (CMS MLN909432).
What Medicare pays (national average)
| Code | National average, varies by locality |
|---|---|
| 99492 | $160.32 |
| 99493 | $144.96 |
| 99494 | $61.46 |
| G2214 | $60.79 |
Actual payment varies by locality and payer and includes the patient's cost sharing.
Where CoCM claims go wrong
Denials are real: in one national study, Medicare denied 32 percent of CoCM and general BHI services billed in 2018 (Marcotte et al., Psychiatric Services, 2021). The study did not list reasons, so the checks below come from the CMS required elements, not from payer denial data.
- Minutes below the threshold for the code billed, or minutes from someone other than the care manager.
- Wrong month type: 99492 billed for a patient already past their first month, or 99493 in the first month.
- G2214 billed alongside 99492, 99493 or 99494, or 99494 billed without its base code.
- General BHI (99484) and CoCM billed for the same patient in the same month.
- No documented consent, initiating visit, registry entry or weekly caseload consultation.
- An FQHC or RHC still billing G0512 for Medicare in 2026.
Print this checklist
Use your browser's Print (Ctrl+P or Cmd+P); the page prints without the menu. Track the month in the free registry template.
Sources
- CMS, Behavioral Health Integration Services, MLN909432, January 2026, checked October 29, 2026.
- AHRQ Academy for Integrating Behavioral Health and Primary Care, New Medicare billing practices for Collaborative Care take effect, March 17, 2026, checked October 29, 2026.
- NC Medicaid, Updated Coverage for Psychiatric Collaborative Care Management, December 30, 2025, checked October 29, 2026.
- Marcotte LM et al., Provision of Collaborative Care Model and General Behavioral Health Integration Services in Medicare, Psychiatric Services, 2021, doi:10.1176/appi.ps.202000265.
Common questions
What is the 50 percent plus one rule for CoCM?
CMS says CPT time rules apply to CoCM: a block of time counts once more than half has passed. That makes 99492 billable from 36 of 70 minutes, 99493 from 31 of 60, and 99494 and G2214 from 16 of 30.
Can FQHCs bill 99492 in 2026?
Yes. G0512 was discontinued as of January 1, 2026, and FQHCs and RHCs bill Medicare for Collaborative Care with 99492, 99493, 99494 and G2214. Medicaid rules vary by state.
Can I bill G2214 and 99494 in the same month?
No. G2214 is not billed in the same month as 99492, 99493 or 99494, and 99494 is only billed as an add-on to 99492 or 99493.
Can I bill 99484 and CoCM in the same month?
Not for the same patient. CMS does not allow general BHI codes in the same month as CoCM codes, though a patient can move between them across months.
Is written consent required for CoCM?
Not for Medicare. Verbal consent is enough if it is documented, including that cost sharing applies. Other payers may differ.
How often must the psychiatric consultant review the caseload?
The CMS code descriptors include participating in a weekly caseload consultation with the psychiatric consultant.
What does Medicare pay for 99493 in 2026?
The 2026 national average non-facility amount is $144.96. Actual payment varies by locality and includes the patient's cost sharing.
Published by Asendar™ (Ignite Synergy™). Education only, not medical, legal or billing advice. Payers set their own rules: verify with your payer and your Medicare Administrative Contractor before you bill.
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