Medicare Reimbursement for G2214 – Initial/Subsequent Psychiatric Collaborative Care Management, First 30 Minutes

HCPCS code G2214 is used to report time spent by a psychiatric consultant in the initial or subsequent phase of collaborative care management for behavioral health conditions. This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount for this code, both at the national level and adjusted by locality, and separately for non-facility and facility settings.

Medicare allowed amount (2026)

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 1 unit per patient per day — Date of Service Edit: Policy. Units above the MUE are denied; some MUEs can be exceeded only with appropriate documentation and modifiers where policy allows.

How the amount is calculated

Medicare pricing starts with three Relative Value Units (RVUs) assigned to the code: physician work, practice expense, and malpractice. Each RVU component is adjusted using the Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed, reflecting local differences in cost of living and practice costs. The adjusted RVUs are summed and multiplied by the annual national conversion factor to produce the allowed amount. Because practice expense RVUs differ depending on whether the service is furnished in a non-facility (e.g., physician office) or facility (e.g., hospital outpatient) setting, the resulting allowed amounts differ between these two settings.

RVUs — work 0.77, practice expense 0.99 (non-facility) / 0.18 (facility), malpractice 0.06 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

• This amount is an estimate only, based on the national Medicare Physician Fee Schedule; actual payment may differ.
• Medicare typically pays 80% of the allowed amount after the patient meets their annual deductible; the beneficiary or secondary payer is responsible for the remainder.
• Modifiers, place-of-service coding, sequestration, and annual budget-neutrality adjustments can all affect the final paid amount.
• Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC), as local adjustments and policy updates may apply.

Frequently asked

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Estimated Medicare Physician Fee Schedule amount. Medicare generally pays 80% after the deductible; actual amounts vary by locality, modifiers, sequestration, and annual updates. Verify with your MAC.