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The Collaborative Care Model (CoCM) uses specific CPT and HCPCS codes to reimburse healthcare practices for providing integrated behavioral health services. Understanding the 2026 CoCM billing codes, time requirements, and reimbursement rates can help practices properly document and bill for eligible services.
For 2026, the primary codes used for CoCM billing include CPT 99492, CPT 99493, CPT 99494, and HCPCS G2214.
In this guide, we’ll explain what each code covers, when it can be billed, and the approximate 2026 national average reimbursement associated with each code.
Important: Reimbursement amounts can vary based on geographic location and other factors. The reimbursement figures discussed below are national averages and should be verified using the current CMS Physician Fee Schedule for your specific location.
What Is the Collaborative Care Model?
The Collaborative Care Model (CoCM) is a behavioral health integration model that coordinates care between a treating physician or other qualified healthcare professional, a Behavioral Health Care Manager, and a psychiatric consultant.
The model is designed to provide structured, collaborative behavioral health services while integrating those services into a patient's overall medical care.
CoCM uses monthly, time-based billing codes to account for behavioral health care management and psychiatric consultation activities.
For CoCM billing, the required time must be performed in consultation with a psychiatric consultant and directed by the treating physician or other qualified healthcare professional.
What Are the 2026 CoCM CPT Codes?
The primary 2026 codes used for the Collaborative Care Model are:
CPT Code 99492: First Month of Collaborative Care
CPT 99492 is used during the first calendar month of CoCM services when the applicable requirements are met.
The code covers the first 70 minutes of time spent by the Behavioral Health Care Manager during the initial month of collaborative care.
A Behavioral Health Care Manager may be a qualified professional with formal education or training in behavioral health, such as a registered nurse, therapist, or licensed social worker.
The approximate 2026 national average reimbursement for CPT 99492 is $160.
When Is 99492 Used?
In general, 99492 is the primary CoCM code for the initial month when the required time and other program requirements have been met.
Healthcare organizations should maintain appropriate documentation of the services provided and the time associated with the patient's care.
CPT Code 99493: Subsequent Months of CoCM
CPT 99493 is used during subsequent calendar months of Collaborative Care Model services.
The code covers 60 minutes of Behavioral Health Care Manager time during a subsequent month of CoCM.
The approximate 2026 national average reimbursement for CPT 99493 is $145.
Unlike 99492, which applies to the initial month, 99493 is used when the patient continues to receive qualifying CoCM services in subsequent months.
CPT Code 99494: Additional CoCM Time
CPT 99494 is an add-on code used when additional CoCM time is provided beyond the time represented by the applicable base code.
The code represents each additional 30 minutes of CoCM time.
CPT 99494 is billed alongside either:
- 99492 during the initial month, or
- 99493 during subsequent months.
The code can be billed up to four times per month.
The approximate 2026 national average reimbursement for each 99494 unit is $61.
Because 99494 is an add-on code, it is not generally billed as a standalone base service. The appropriate base code must also be considered.
HCPCS Code G2214: Alternative CoCM Base Code
G2214 provides an alternative billing option when the requirements for the higher-level CoCM codes are not met.
The code is used for the first 30 minutes of CoCM time when the qualifications for 99492 or 99493 are not met.
The approximate 2026 national average reimbursement for G2214 is $61.
Importantly, G2214 cannot be billed with the other CoCM codes discussed in this guide.
Who Is Involved in the Collaborative Care Model?
CoCM is built around collaboration between several members of the care team.
Treating Physician or Qualified Healthcare Professional
The treating physician or other qualified healthcare professional directs the patient's care and oversees the collaborative behavioral health services.
Behavioral Health Care Manager
The Behavioral Health Care Manager provides many of the ongoing behavioral health care management services associated with CoCM.
Depending on the organization and program structure, this role may be performed by professionals such as registered nurses, therapists, or licensed social workers with appropriate behavioral health training.
Psychiatric Consultant
The psychiatric consultant provides consultation as part of the collaborative care team.
The CoCM billing structure requires the applicable time to be performed in consultation with the psychiatric consultant and directed by the treating physician or other qualified healthcare professional.
Is an Initiating Visit Required for CoCM?
An initiating visit may be separately billable when required, including for patients who have not been seen by the physician or other qualified healthcare professional within the applicable preceding period.
The transcript discussed in this guide specifies that an initiating visit is required for patients who have not been seen within one year prior to the start of services.
Practices should verify the current CMS requirements and payer-specific rules when determining whether an initiating visit is required for a particular patient.
Is Patient Consent Required for CoCM?
Patient consent is required before beginning behavioral health integration services under the applicable requirements.
Practices should make sure consent is obtained and appropriately documented before initiating qualifying services.
As with other CoCM billing requirements, organizations should maintain documentation that demonstrates compliance with applicable Medicare, payer, and program requirements.
Why Accurate CoCM Documentation Matters
CoCM involves multiple members of the care team, recurring monthly services, time-based billing, psychiatric consultation, patient consent, and other documentation requirements.
As a result, organizations need workflows that make it easy to:
- Track care management time
- Document behavioral health services
- Coordinate activities between care team members
- Maintain patient care plans
- Record interventions and follow-up activities
- Support billing documentation
- Monitor program performance
Technology can help organizations create more consistent workflows while reducing the administrative burden associated with managing collaborative care programs.
How ThoroughCare Supports CoCM
ThoroughCare provides care coordination software designed to help healthcare organizations streamline value-based care programs, including the Collaborative Care Model (CoCM).
A care coordination platform can help organizations manage workflows, document patient interactions, coordinate care team activities, and support the operational processes associated with behavioral health and other value-based care programs.
ThoroughCare also supports other care management programs, including Chronic Care Management (CCM), Behavioral Health Integration (BHI), and Remote Patient Monitoring (RPM).
2026 CoCM CPT Code FAQs
What are the CPT codes for CoCM in 2026?
The primary codes discussed for the 2026 Collaborative Care Model are 99492, 99493, and 99494, along with HCPCS G2214 as an alternative base code when the applicable requirements for 99492 or 99493 are not met.
What is CPT 99492?
CPT 99492 is used for the initial month of Collaborative Care Model services and covers the first 70 minutes of qualifying Behavioral Health Care Manager time.
What is CPT 99493?
CPT 99493 is used for subsequent months of CoCM and covers 60 minutes of qualifying Behavioral Health Care Manager time.
What is CPT 99494?
CPT 99494 is an add-on code for each additional 30 minutes of qualifying CoCM time. It can be billed alongside 99492 or 99493 when the applicable requirements are met.
How many times can 99494 be billed?
According to the requirements discussed in this guide, 99494 can be billed up to four times per month.
What is G2214?
G2214 is an alternative base code for the first 30 minutes of CoCM time when the applicable requirements for 99492 or 99493 are not met. G2214 cannot be billed with the other CoCM codes discussed here.
How much does CoCM pay in 2026?
Approximate national average reimbursement amounts discussed in this guide are $160 for 99492, $145 for 99493, and $61 for 99494 and G2214. Actual payment varies by location and payer, so practices should verify current rates using the CMS Physician Fee Schedule.
Does CoCM require patient consent?
Yes. Patient consent is required before beginning applicable behavioral health integration services.
Does CoCM require an initiating visit?
An initiating visit may be required and can be separately billable under the applicable circumstances. Practices should verify current CMS requirements, including the patient's recent visit history, before billing.