Policy
CMS Proposes Major Payment Gains for Collaborative Care in the 2027 Medicare Fee Schedule
Jul 14, 2026 - 11:44am
Proposal also advances measurement-informed care, CCBHCs, and community health workers
WASHINGTON, D.C. (July 2026): CMS released the proposed CY 2027 Medicare Physician Fee Schedule, with significant payment gains for Collaborative Care, a top Path Forward priority. The fee schedule sets Medicare payment for more than 10,000 services, and commercial insurers and Medicaid programs often follow its lead.
CMS proposes higher work values for every Collaborative Care code, recognizing the joint decision-making of the treating practitioner and the psychiatric consultant. The American Psychiatric Association’s analysis of the proposed rates:
| Code | Current work RVU | Proposed work RVU | Change |
|---|---|---|---|
| 99492 (initial month) | 1.88 | 2.75 | +46.3% |
| 99493 (subsequent month) | 2.05 | 2.26 | +10.2% |
| 99494 (each additional 30 minutes) | 0.82 | 1.13 | +37.8% |
| G2214 (first 30 minutes in a month) | 0.77 | 1.13 | +46.8% |
Work RVUs are the point values Medicare assigns to each service based on time, skill, and effort. Higher values mean higher payment. Source: American Psychiatric Association.
CMS also proposes raising the labor rate for the behavioral health care manager, the patient’s main point of contact in the model, from $0.57 to $0.70.
The proposal advances other Path Forward care solutions too:
- Measurement-informed care: new behavioral health MIPS Value Pathways that pair chronic condition management with routine tracking using validated screening tools
- CCBHCs: automatic Medicare Part B processing of CCBHC crisis and outpatient claims, cutting paperwork and preventing wrongful bills
- Community health workers: removal of the requirement for a clinical supervisor to be on site during Principal Illness Navigation services
The American Psychiatric Association leads the coalition’s fee schedule work. If finalized, the gains start with Medicare and can extend to commercial plans and to the 37 state Medicaid programs that cover Collaborative Care. The final rule is expected in November.