Collaborative Care (CoCM) billing calculator
Estimate what a psychiatric collaborative care program brings in from Medicare, in your locality, and how much care manager time it takes. Built from CMS's own 2026 fee schedule files. It runs in your browser and sends nothing anywhere.
In the Collaborative Care Model, a primary care practice treats common mental health conditions with a behavioral health care manager and a psychiatric consultant who reviews the caseload. Medicare pays the primary care practice through four codes. For 2026, the national office rate for most clinicians is $160.32 for the first month (99492), $144.96 for each later month (99493), $61.46 for each extra 30 minutes (99494), and $60.79 for a shorter month (G2214).
Estimate your program
RHCs and FQHCs are paid the national non-facility rate, so locality doesn't apply.
From CMS's 2026 GPCI file.
Two conversion factors apply starting in 2026.
Billed 99492 in their first month
Billed 99493 in a later month
Each is one 99494; depends on how sick your caseload is
Patients billed G2214 instead of the full code
Optional, to see what's left over
Optional
| Code | Your rate | Units | Monthly |
|---|
Estimates the Medicare allowed amount at CMS rates. Actual payment can differ with claim adjustments, other payers, and whether each patient's time actually meets the code. The allowed amount includes the patient's coinsurance.
2026 national rates
National amounts before any locality adjustment, for most clinicians (conversion factor $33.4009). Qualifying APM participants use $33.5675, which pays slightly more.
| Code | What it covers | Office | Facility |
|---|---|---|---|
| 99492 First month of collaborative care | 70 minutes of care manager time in the first calendar month | $160.32 | $82.17 |
| 99493 Each later month | 60 minutes of care manager time in a later calendar month | $144.96 | $89.51 |
| 99494 Add-on, each extra 30 minutes | Added to 99492 or 99493 for each additional 30 minutes | $61.46 | $36.07 |
| G2214 Shorter month | 30 minutes of care manager time in a first or later month | $60.79 | $33.73 |
| 99484 General behavioral health integration | At least 20 minutes of clinical staff time in a month; not billed in the same month as CoCM | $57.45 | $38.75 |
Computed as total relative value units times the conversion factor, from CMS's RVU26D, Physician Fee Schedule October 2026 release (released 08/26/2026). Code descriptions are our plain-language summaries, not CPT descriptors.
Rules that decide whether you can bill
- The care manager's time drives the codes: at least 70 minutes in the first month and at least 60 in later months. CMS says CPT time rules apply, so check current CPT guidance for when a code's time is met.
- The billing practitioner can be a physician of any specialty or a nonphysician practitioner whose scope includes E/M services. CMS says it generally wouldn't expect psychiatrists to bill these codes.
- The psychiatric consultant and care manager work as employees or contractors of the billing practice. The consultant isn't generally expected to see the patient or prescribe, and doesn't have to participate in Medicare.
- The patient has to consent, which can be verbal if it's documented, and has to be told that cost sharing applies.
- New patients, and patients not seen within a year, need an initiating visit with the billing practitioner.
- General behavioral health integration (99484) can't be billed in the same month as CoCM.
- Starting in 2026, practices billing advanced primary care management can instead use add-on codes G0568, G0569, and G0570, which aren't time-based.
What's coming in 2027
CMS's proposed rule for 2027 would lower the conversion factors to $33.17 for qualifying APM participants and $32.84 for everyone else, because a one-year 2.5% increase for 2026 ends. The proposal also has a section on the CoCM codes. None of this is final until CMS publishes the final rule, usually in November, and this calculator will switch to 2027 rates when they take effect.
Frequently asked questions
How much does Medicare pay for collaborative care in 2026?
At the 2026 national rate for most clinicians, CMS pays $160.32 for 99492 (first month), $144.96 for 99493 (later months), $61.46 for each 99494 add-on, and $60.79 for G2214, in an office setting. Your local rate is adjusted by your Medicare locality.
Who bills the collaborative care codes?
The treating practitioner, usually in primary care. CMS says physicians of any specialty and nonphysician practitioners whose scope includes E/M services can bill. CMS also says it generally wouldn't expect psychiatrists to bill the CoCM codes, because the psychiatric consultant's work is part of what the codes pay for.
Can a psychiatric consultant bill Medicare separately for collaborative care?
Not for the CoCM codes. Medicare pays the billing practitioner, and the psychiatric consultant and care manager work as employees or contractors of that practice. How the consultant is paid is set by their contract with the practice.
Do patients pay anything for collaborative care?
Yes. Part B cost sharing applies, so patients owe coinsurance unless other coverage picks it up, and the practice has to tell them that when it gets their consent.
How do FQHCs and rural health clinics bill collaborative care in 2026?
Starting January 1, 2026, rural health clinics and FQHCs report the individual codes (99492, 99493, 99494, and G2214) instead of G0512, and CMS pays them at the national non-facility rate.
How we built this
Rates come straight from CMS's RVU26D, Physician Fee Schedule October 2026 release (released 08/26/2026) relative value file: work, practice expense, and malpractice relative value units for each code, the two conversion factors, and the geographic practice cost indices for every Medicare locality. Your rate is each unit times your locality's index, added up, times the conversion factor. Billing rules come from CMS's Behavioral Health Integration booklet and FAQs and the rural health clinic booklet. This is an educational estimate, not billing, legal, or compliance advice.
Cite as: Refai S. Collaborative Care (CoCM) Billing Calculator. shrinkiatry; September 29, 2026. https://shrinkiatry.com/tools/collaborative-care-billing-calculator/
Sources
- Centers for Medicare & Medicaid Services. PFS relative value files, RVU26D, Physician Fee Schedule October 2026 release (released 08/26/2026). https://www.cms.gov/medicare/payment/fee-schedules/physician/pfs-relative-value-files/rvu26d
- CMS. Behavioral Health Integration Services (MLN909432). https://www.cms.gov/files/document/mln909432-behavioral-health-integration-services.pdf
- CMS. Behavioral Health Integration FAQs. https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/behavioral-health-integration-faqs.pdf
- CMS. Information for Rural Health Clinics (MLN006398). https://www.cms.gov/files/document/mln006398-information-rural-health-clinics.pdf
- CMS. CY 2026 Physician Fee Schedule final rule, 90 FR 49266 (November 5, 2025). federalregister.gov
- CMS. CY 2027 Physician Fee Schedule proposed rule fact sheet. https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2027-medicare-physician-fee-schedule-proposed-rule
Reviewed by Shariq Refai, MD, MBA, FAPA, a board-certified psychiatrist. Last reviewed September 29, 2026.
Go deeper
Read the Collaborative Care billing codes explainer, see real programs in the Innovation Atlas, and size a panel with the panel size calculator.