NC Medicaid Updates Coverage for Psychiatric Collaborative Care Management

NC Medicaid has announced important updates to coverage for Psychiatric Collaborative Care Management (CoCM) services, effective December 31, 2025. This change impacts both NC Medicaid Direct and NC Medicaid Managed Care programs.

Key Update: End-Dating of HCPCS Code G0512

The Healthcare Common Procedure Coding System (HCPCS) code G0512 will be end-dated on Dec. 31, 2025. This means Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) must transition to reporting CoCM services using individual CPT and HCPCS codes that previously comprised G0512.

Per Centers for Medicare & Medicaid Services (CMS) guidance, the following codes should now be used:

99492 – Initial psychiatric collaborative care management, first 70 minutes in the first calendar month.
99493 – Subsequent psychiatric collaborative care management, first 60 minutes in a subsequent month of behavioral health care manager activities.
G2214 – Initial or subsequent psychiatric collaborative care management, first 30 minutes in a month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified healthcare professional.
99494 – Initial or subsequent psychiatric collaborative care management, each additional 30 minutes in a calendar month (up to four 30-minute sessions allowed per month).

Why This Matters

This update ensures alignment with CMS requirements and supports accurate reporting for CoCM services. Providers should review their billing practices and update systems to reflect these changes before the effective date.

Background

This bulletin serves as an update to the Sept. 17, 2025 bulletin on Psychiatric Collaborative Care Management coverage. NC Medicaid continues to emphasize integrated behavioral health care and collaborative models to improve patient outcomes.