How much does Medicare pay for CPT 99493?

Medicare allowed an average of $124.05 per service and paid $97.87 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $317.24, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 99493?

Follow-up psychiatric collaborative care management, subsequent calendar month, first 60 minutes. It was billed 80,997 times to 25,798 Medicare beneficiaries by 383 providers in 2024.

Does 99493 pay differently in an office than a hospital?

Yes. The allowed amount averaged $125.09 in an office setting and $100.17 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 99493 most?

Nurse Practitioner, with 29,791 services from 166 clinicians. Next are Physician Assistant, Internal Medicine, Family Practice.

CPT 99493

Follow-up psychiatric collaborative care management, subsequent calendar month, first 60 minutes

$124.05Medicare-allowed amount per service, averaged across 80,997 services

Providers submitted

$317.24

Asking price, not received

Medicare allowed

$124.05

The fee schedule figure

Medicare paid

$97.87

Balance is patient coinsurance

Providers submitted an average of $317.24 for this code and Medicare allowed $124.05 — 2.6× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $97.87 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $125.09
Hospital / facility: $100.17

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 77,629 services were billed in an office setting and 3,368 in a facility.

Services: 80,997
Beneficiaries: 25,798
Providers billing it: 383
Total allowed: $10,047,678

What Medicare pays for CPT 99493

Across 80,997 services billed by 383 providers to 25,798 beneficiaries, Medicare allowed an average of $124.05 per service. That is 3.1 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 99493

Specialty	Services	Beneficiaries	Avg allowed	Providers
Nurse Practitioner	29,791	9,895	$117.91	166
Physician Assistant	21,397	7,426	$117.87	46
Internal Medicine	13,479	3,878	$130.94	60
Family Practice	7,417	2,144	$135.13	49
Psychiatry	1,664	379	$138.22	6
Cardiology	1,059	253	$148.74	12
Interventional Cardiology	862	211	$149.90	9
Emergency Medicine	823	246	$140.46	3
Interventional Pain Management	726	176	$135.40	3
Geriatric Medicine	670	185	$152.45	4
Radiation Oncology	523	278	$139.88	1
Anesthesiology	449	159	$124.03	5
Psychologist, Clinical	438	92	$106.71	1
Neurology	363	99	$145.12	6
Intensive Cardiac Rehabilitation	321	90	$151.74	1

99493 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
New York	19,271	$121.27	$93.58	27
Florida	11,814	$120.20	$94.73	54
Virginia	6,790	$122.15	$97.03	17
Georgia	5,130	$118.53	$92.89	13
Minnesota	5,049	$122.05	$98.00	41
Texas	5,038	$124.97	$104.63	13
California	4,363	$140.64	$100.05	38
New Jersey	3,760	$138.27	$105.14	13
Pennsylvania	3,614	$122.61	$95.38	12
Arizona	2,728	$128.67	$101.58	31
Maryland	2,656	$135.77	$100.51	20
Wisconsin	2,166	$113.11	$93.56	21
Michigan	2,116	$128.99	$100.10	20
Rhode Island	1,713	$120.53	$93.13	1
Oklahoma	750	$111.63	$90.04	2
Colorado	722	$124.18	$95.40	19
Tennessee	593	$119.14	$94.35	3
Massachusetts	572	$136.67	$99.49	11
Hawaii	313	$140.56	$109.29	1
Illinois	265	$141.97	$104.46	3
South Carolina	237	$112.55	$96.47	2
District of Columbia	208	$134.28	$95.49	3
North Carolina	207	$129.41	$109.04	3
Oregon	145	$101.07	$77.27	2
Indiana	138	$107.36	$89.79	2
Montana	124	$132.47	$100.97	3
Ohio	120	$121.80	$91.17	2
Washington	81	$152.89	$109.04	1
Louisiana	76	$96.98	$79.31	1
Nebraska	74	$128.91	$109.61	1
Missouri	64	$109.16	$91.71	1
Kentucky	58	$132.58	$109.61	1
Nevada	42	$123.98	$93.17	1

Related codes

99490Chronic care management services$59.70
99439Chronic care management services for two or more chronic conditions$46.13
99497Advance care planning$73.95
99457Management using the results of remote vital sign monitoring per calen$48.61
99458Management using the results of remote vital sign monitoring per calen$39.11
99454Remote monitoring of physiologic parameters$47.97
99489Complex chronic care management services for two or more chronic condi$67.00
99442Telephone medical discussion$83.84
99443Telephone medical discussion$120.39
99487Complex chronic care management services for two or more chronic condi$124.70
99496Transitional care management services for problem of high complexity$252.87
99426Principal care management services for a single high-risk disease$60.08

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.