Behavioral health CPT codes, or BHI CPT codes, are the billing framework that allows healthcare organizations to get reimbursed for behavioral health integration services delivered in primary care and collaborative care settings.
The American Medical Association (AMA) maintains these codes, while CMS determines Medicare reimbursement rates and coverage policies for each.
The two main billing pathways are General Behavioral Health Integration (BHI) and the Psychiatric Collaborative Care Model (CoCM).
Each uses different CPT and HCPCS codes with different time thresholds, team requirements, and documentation rules — and the two pathways cannot be billed for the same patient in the same month.
The sections ahead cover every code, when to use it, and what trips up billing teams most often.
- General BHI codes (99484 and G0323)
- CoCM codes (99492, 99493, 99494, and G2214)
- Team conference codes (99366, 99367, 99368)
- Which codes can and cannot be billed together
- Documentation requirements and common denial triggers
What are behavioral health CPT codes and which model should you bill?
BHI CPT codes represent two separate Medicare-recognized care models for integrating behavioral health into primary care. The right code depends on your care team structure, the patient’s complexity, and whether you operate a formal collaborative care program with psychiatric consultation.
The decision flow below shows which model — and which code — fits each clinical scenario.
BHI Code Selection Framework
Which behavioral health billing model fits?
Do you have a psychiatric consultant + care manager + patient registry?
YES → Collaborative Care Model
First month, 70+ min → 99492
Later months, 60+ min → 99493
Each extra 30 min → 99494
Under threshold, 30+ min → G2214
NO → General BHI
Clinical staff, 20+ min → 99484
Eligible MH professional billing independently → G0323
BHI and CoCM are mutually exclusive — you cannot bill both for the same patient in the same month
Which codes fall under general BHI?
General Behavioral Health Integration is the simpler model.
It does not require a psychiatric consultant, patient registry, or weekly caseload review — making it accessible to primary care practices that integrate behavioral health monitoring without a formal collaborative care team.
CPT 99484
CPT 99484 is the primary General BHI code. It covers at least 20 minutes of clinical staff time per calendar month for behavioral health care management activities under the direction of a physician or qualified healthcare professional (QHP).
Qualifying activities include the following.
- Care plan development and revision
- Communication with other treating providers
- Initial assessment or ongoing tracking using validated scales (PHQ-9, GAD-7)
- Care coordination and follow-up monitoring
- Patient outreach and engagement
Clinical staff can deliver BHI services under general supervision — the billing practitioner does not need to be physically present. CPT 99484 is billed once per patient per month regardless of how much time exceeds the 20-minute threshold, and it cannot be billed in the same month as CoCM codes (99492–99494) for the same patient.
HCPCS G0323
G0323 is a CMS HCPCS code that allows certain behavioral health professionals — including clinical psychologists, licensed clinical social workers, mental health counselors, and marriage and family therapists — to bill BHI-type services under their own credentials.
Eligibility depends on provider type, CMS enrollment status, and applicable rules. G0323 covers at least 20 minutes per calendar month, paralleling 99484’s structure for a different provider set.
Which codes apply to the collaborative care model?
The Psychiatric Collaborative Care Model (CoCM), developed at the University of Washington AIMS Center, is a structured team-based program requiring three participants:
- A treating physician/QHP
- A behavioral health care manager
- A psychiatric consultant
…plus a patient registry and regular caseload review.
CoCM codes reimburse at higher rates than General BHI but demand significantly more operational infrastructure.
CPT 99492
CPT 99492 covers the first 70 minutes of behavioral health care manager activities during the initial month of CoCM services.
Qualifying activities include patient outreach, initial assessment with validated rating scales, treatment plan development, care coordination, and psychiatric consultant review. Billed only once per patient during the first calendar month of CoCM enrollment.
CPT 99493
CPT 99493 covers the first 60 minutes of care manager activities in each subsequent month of CoCM. The lower time threshold reflects that initial intake work is already complete.
The scope of qualifying activities remains the same — ongoing monitoring, care plan adjustment, coordination, and psychiatric review.
CPT 99494
CPT 99494 is the add-on code for each additional 30-minute increment beyond the base CoCM threshold. It must be billed alongside 99492 or 99493 — never alone.
The number of add-on units billable per month may vary by payer, so verify limits against your specific Medicare Administrative Contractor (MAC) guidance and commercial payer rules before submitting multiple units.
HCPCS G2214
G2214 is a CMS HCPCS code covering the first 30 minutes of CoCM activities when time falls below the CPT thresholds (70 or 60 minutes).
CMS created G2214 to give practices a billing option for months where meaningful CoCM work happens but does not reach the higher time floors. All CoCM requirements (team structure, registry, caseload review) still apply when billing G2214.
How do team conference codes fit into behavioral health billing?
Team conference codes are separate from BHI and CoCM but apply when interdisciplinary care coordination meetings occur. They capture the time spent in structured medical team conferences — a common activity in integrated behavioral health settings.
| Code | Conference type | Patient present? | Who bills? |
| 99366 | Team conference | Yes (patient/family) | QHP who has seen the patient |
| 99367 | Team conference | No | Physician or QHP |
| 99368 | Team conference | No | Non-physician QHP |
CPT 99366 requires that the billing professional has performed a face-to-face evaluation within a recent clinical timeframe.
Codes 99367 and 99368 cover conferences without the patient or family present — 99367 is billed by a physician, while 99368 is billed by a non-physician qualified healthcare professional.
Conference time must involve a minimum of three qualified professionals from different disciplines.
Can you bill BHI codes together with other services?
Billing combination rules are one of the most common sources of behavioral health claim denials. Some code pairs are allowed, some are explicitly prohibited, and some depend on specific CMS conditions.
BHI Billing Combination Matrix
Can you bill these codes together?
99484 + 99492/99493 — Never. BHI and CoCM are mutually exclusive in the same month.
99484 + CCM (99490) — Allowed when requirements are independently met and time is not double-counted. Verify against current CMS guidance.
99492 + 99494 — Required combination. 99494 is an add-on that must be billed with a base CoCM code.
BHI + psychotherapy (90832–90837) — May be allowed if services are clinically distinct and time is not overlapping. Payer rules vary.
99494 alone — Never. Add-on code requires a base CoCM code on the same claim.
99366–99368 + BHI or CoCM — Allowed. Team conference codes are separate services.
Always verify combination rules against current CMS and payer-specific guidance before billing
The most common combination error is billing 99484 and 99492 (or 99493) for the same patient in the same calendar month. BHI and CoCM are different care models with different team structures — CMS treats them as mutually exclusive billing pathways for a given patient in any single month.
What documentation supports BHI and CoCM claims?
Every BHI and CoCM claim must be backed by documentation that proves the required elements were met. Missing records are the fastest route to denial or post-payment recoupment.
For General BHI (99484), documentation should include the following.
- Direction from the billing physician or QHP
- Care plan with measurable treatment goals
- Cumulative time log showing staff activities and total minutes
- Follow-up monitoring results (validated scales where appropriate)
- A medically necessary behavioral health diagnosis (ICD-10-CM codes such as F32.x, F41.x, F10.x–F19.x) supported by clinical evidence
For CoCM (99492–99494), add these requirements.
- Patient registry entry with tracking data
- Documented psychiatric consultant recommendations
- Evidence of regular (typically weekly) caseload review
- Care plan revisions when patient outcomes change
- Patient consent for CoCM participation
Time tracking is the weakest link in most practices. Staff often perform qualifying activities but fail to log minutes accurately, which leaves the claim unsupportable under audit.
Building time-tracking into daily workflow — rather than reconstructing logs at month-end — is the operational standard that separates sustainable billing from write-offs.
What billing mistakes cause the most BHI denials?
The most common BHI billing errors follow predictable patterns that repeat across practices.
- Billing 99494 without a base CoCM code on the same claim
- Missing the required initiating visit before the first BHI or CoCM claim
- Billing G2214 without meeting all CoCM team and registry requirements
- Submitting CoCM codes without a psychiatric consultant on the care team
- Using 99492 beyond the first calendar month instead of switching to 99493
- Using overly broad diagnoses without supporting clinical documentation
- Billing 99484 and CoCM codes for the same patient in the same month
- Logging time below the minimum threshold for the billed code
- Failing to maintain a patient registry for CoCM services
For practices with recurring denials, tracking denial reason codes by month and mapping them back to specific documentation or workflow failures is the fastest path to improvement.
Most BHI denial patterns are structural (workflow gaps, missing templates, inadequate time tracking) rather than individual coder errors — which means the fix is a process change, not staff retraining alone.
Get every BHI code billed correctly the first time
BHI and CoCM billing is high-value revenue that many practices either miss entirely or lose to preventable denials. Whether you’re launching a BHI program, scaling CoCM, or cleaning up existing behavioral health billing workflows, accurate coding and compliant documentation are what protect that revenue.
- Correct code selection based on care model and team structure
- Time tracking systems that hold up under audit
- Documentation that satisfies every CMS requirement
- Denial management for rejected BHI and CoCM claims
MedHeave handles behavioral health billing for practices that want every BHI and CoCM code submitted accurately — contact us to capture the revenue you’ve earned.
Frequently asked questions
Questions below address remaining gaps and top search queries.
CPT 99484 covers General Behavioral Health Integration — 20 minutes of clinical staff time per month, no psychiatric consultant required, no patient registry needed. CPT 99492 covers the initial month of the Collaborative Care Model — 70 minutes of behavioral health care manager time per month, plus a psychiatric consultant, patient registry, and weekly caseload review. CoCM (99492) reimburses at a higher rate but demands a structured three-member care team. Practices without psychiatric consultation access typically bill under 99484.
CPT 99484 is the primary billing code for General Behavioral Health Integration care management. It requires at least 20 minutes of clinical staff time per calendar month for activities like patient assessment, care coordination, treatment plan management, and follow-up monitoring. The billing practitioner directs the services and bills under their NPI. Unlike CoCM codes, 99484 does not require a psychiatric consultant or patient registry, which makes it the more accessible BHI option for primary care practices.
CPT codes 99366–99368 cover interdisciplinary medical team conferences in behavioral health settings. Code 99366 is for conferences with the patient or family present, billed by a qualified healthcare professional who has recently evaluated the patient. Codes 99367 (physician) and 99368 (non-physician QHP) cover conferences without the patient present. All three require participation from at least three qualified professionals from different disciplines. Team conference codes are not BHI or CoCM codes — they are separate services that can be billed alongside BHI or CoCM when applicable.
BHI care management (99484) and psychotherapy (90832–90837) may potentially be billed for the same patient, but the services must be clinically distinct, the time cannot overlap, and payer-specific rules apply. BHI covers care coordination and monitoring activities — not therapy itself. If a practice provides both psychotherapy and BHI care management for the same patient in the same month, the documentation must clearly show that each service met its own requirements independently. Verify current CMS and commercial payer combination rules before billing both.
The most commonly billed mental health CPT codes fall into several categories. For psychotherapy, codes 90832 (16–37 min), 90834 (38–52 min), and 90837 (53+ min) are the primary session-based codes. For behavioral health integration, 99484 (General BHI) and 99492–99494 (CoCM) cover care management. For psychiatric evaluation, 90791 (diagnostic evaluation) and 90792 (evaluation with medical services) apply. HCPCS codes G0323 and G2214 provide additional Medicare billing options for eligible professionals and short-time CoCM encounters.
