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99494 first/sbsq psyc collab care

Evaluation & Management

Also known as: psychiatric care management, behavioral specialist consultation

Behavioral health specialist care management or psychiatric consultation provided by non-physician clinician during initial or subsequent visit.

In Plain Language

mental health specialist consultation

Clinical Context

Used when licensed behavioral health specialist (social worker, psychologist, psychiatric nurse practitioner) provides psychiatric care management or consultation.

RVU Breakdown

Work RVU0.82
Total RVU0.82

Est. Medicare Payment

$27.39

National estimate based on 2026 CMS PFS Conversion Factor ($33.40). Actual payment varies by locality (GPCI adjustment).

Billing & Documentation

E&M codes require documentation of medical decision-making (MDM) complexity or total time spent on the encounter. For 2026, time-based coding includes all physician time on the date of the encounter.

How This Code Compares

With a work RVU of 0.82, this code ranks in the 20th percentile among Evaluation & Management codes — 1.9x below the median (1.54). The highest wRVU in this category is 18.46.

Specialties

PsychiatryBehavioral HealthMental Health

Frequently Asked Questions

What is CPT code 99494?

CPT 99494 (first/sbsq psyc collab care) is a Evaluation & Management code. Behavioral health specialist care management or psychiatric consultation provided by non-physician clinician during initial or subsequent visit.

Who uses CPT code 99494?

CPT 99494 is used by Psychiatry, Behavioral Health, Mental Health. Used when licensed behavioral health specialist (social worker, psychologist, psychiatric nurse practitioner) provides psychiatric care management or consultation.

When is CPT 99494 used?

Used when licensed behavioral health specialist (social worker, psychologist, psychiatric nurse practitioner) provides psychiatric care management or consultation.

Track This Code in RVU Edge

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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.