Key facts for G2214
- Medicare payment
- $60.79
- PFS non-facility, national; facility $33.73
- Coverage code
- C
- carrier judgment, so the Medicare contractor decides coverage
- Practitioner MUE
- 1
- MAI 2
- NCCI PTP pairs
- 0
- practitioner file
- LCDs and articles
- 1 / 1
TL;DR
HCPCS Level II G2214 reads "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 health care professional" in the October 2026 file; it dates from 2021. Under the 2026 physician fee schedule (October release) G2214 carries 0.77 work, 0.99 practice-expense and 0.06 malpractice RVUs, which at $33.4009 per RVU pays $60.79 non-facility and $33.73 facility before the locality adjustment. Qualifying APM participants get $61.09 at $33.5675. Its 2026 Q4 MUEs per date of service: practitioner 1 (MAI 2, Code Descriptor / CPT Instruction); hospital outpatient 1 (MAI 2, Code Descriptor / CPT Instruction). 1 active LCD and 1 billing and coding article list G2214 across 4 states: L37638 (Health and Behavior Assessment/Intervention), A56562. HCPCS record: BETOS M5D (specialist - other); pricing indicator 11; type of service 1 (medical care). Nearby codes: G2212, G2211, G2250, G2251.
G2214 descriptor and code status
The October 2026 HCPCS Level II file describes G2214 as “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 health care professional”. It sits in the G section (procedures and professional services, temporary), listed with the other G codes. Although searches often call it the "G2214 CPT code", G2214 is a HCPCS Level II code maintained by CMS, not an AMA CPT code; both go in the same procedure-code field on the claim.
| Field | Value |
|---|---|
| Short descriptor | Init/sub psych care m 1st 30 |
| Added to HCPCS | 2021-01-01 |
| Last action | N (no maintenance), effective 2021-01-01 |
| Coverage code | C: carrier judgment, so the Medicare contractor decides coverage |
| Pricing indicator | 11: physician fee schedule, priced with national RVUs |
| BETOS category | M5D: specialist - other |
| Type of service | 1: medical care |
Medicare payment for G2214
Under the 2026 physician fee schedule (October release) G2214 carries 0.77 work, 0.99 practice-expense and 0.06 malpractice RVUs, which at $33.4009 per RVU pays $60.79 non-facility and $33.73 facility before the locality adjustment. Qualifying APM participants get $61.09 at $33.5675. The amounts below are national figures from the October 2026 CMS files; the contractor applies the locality, rural or state adjustment and the beneficiary's cost sharing.
Physician fee schedule (RVU26D)
Status A: active: paid separately under the physician fee schedule when covered. Global period XXX (global surgery concept does not apply); PC/TC indicator 0 (physician service; the professional/technical split does not apply).
| Component | Non-facility | Facility |
|---|---|---|
| Work RVU | 0.77 | 0.77 |
| Practice expense RVU | 0.99 | 0.18 |
| Malpractice RVU | 0.06 | 0.06 |
| Total RVUs | 1.82 | 1.01 |
| National payment (CF $33.4009) | $60.79 | $33.73 |
| Qualifying APM participant (CF $33.5675) | $61.09 | $33.90 |
- Multiple procedures (modifier 51): no multiple-procedure reduction
- Bilateral (modifier 50): 150% bilateral adjustment does not apply
- Assistant at surgery: assistant at surgery paid only with documentation; co-surgeons: co-surgeons not permitted; team surgery: team surgeons not permitted
- Physician supervision of diagnostic procedures: supervision concept does not apply
Hospital outpatient (OPPS Addendum B)
Status indicator S (Procedure or service, not discounted when multiple), APC 5822 (Level 2 Health and Behavior Services), national unadjusted payment $103.79 with a minimum unadjusted copayment of $20.76.
Medically Unlikely Edits for G2214
Its 2026 Q4 MUEs per date of service: practitioner 1 (MAI 2, Code Descriptor / CPT Instruction); hospital outpatient 1 (MAI 2, Code Descriptor / CPT Instruction). The practitioner MUE is a date-of-service policy edit: units above the limit deny even when split across lines, and appeals rarely succeed.
| Setting | MUE (units/DOS) | MAI | CMS rationale |
|---|---|---|---|
| Practitioner services | 1 | 2 Date of Service Edit: Policy | Code Descriptor / CPT Instruction |
| Facility outpatient hospital | 1 | 2 Date of Service Edit: Policy | Code Descriptor / CPT Instruction |
The MUE lookup for G2214 shows every setting next to any other code on the same claim.
NCCI edits and add-on rules
No active practitioner PTP pair lists G2214 in v323r0.
G2214 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.
Pair counts show exposure, not the answer for one claim. Check G2214 against a second code to see whether the pair bundles and whether a modifier can separate the services.
Medicare coverage policies for G2214
1 active Local Coverage Determination and 1 billing and coding article list G2214. Each applies only in its contractor's jurisdiction, and the article carries the diagnosis codes that support the item or service.
- Health and Behavior Assessment/Intervention, LCD L37638 · Palmetto GBA
| Article | Title | Contractor(s) | Related LCD |
|---|---|---|---|
| A56562 | Billing and Coding: Health and Behavior Assessment/Intervention | Palmetto GBA | L37638 |
Denials to expect on G2214
the diagnosis or documentation does not meet the LCD or billing article that lists G2214
the modifier reported is inconsistent with the code
the claim lacks information needed to adjudicate the line, such as an order, NPI or required modifier
Where QuickIntell fits for G2214 claims
QuickCode supports qualified coder review of units, modifiers and NCCI pairs for G2214 before the claim leaves, and QuickRCM carries claim readiness and the denial follow-up when an edit or coverage policy is missed.
Frequently asked questions: HCPCS G2214
What does HCPCS code G2214 describe?
"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 health care professional" (short descriptor "Init/sub psych care m 1st 30"), in the G section (procedures and professional services, temporary). Added 2021-01-01.
Is G2214 a CPT code?
No. G2214 is a CMS HCPCS Level II code; CPT codes are the AMA's five-character set. Searches for "G2214 CPT code" mean this Level II code.
What does Medicare pay for G2214?
Under the 2026 physician fee schedule (October release) G2214 carries 0.77 work, 0.99 practice-expense and 0.06 malpractice RVUs, which at $33.4009 per RVU pays $60.79 non-facility and $33.73 facility before the locality adjustment. Qualifying APM participants get $61.09 at $33.5675.
How many units of G2214 can be billed per day?
Its 2026 Q4 MUEs per date of service: practitioner 1 (MAI 2, Code Descriptor / CPT Instruction); hospital outpatient 1 (MAI 2, Code Descriptor / CPT Instruction). For the practitioner MUE (MAI 2), units above 1 deny for the whole day as a policy limit; denials arrive as CARC 151.
Does Medicare cover G2214?
Coverage code C (carrier judgment, so the Medicare contractor decides coverage). 1 active LCD and 1 billing and coding article list G2214 across 4 states: L37638 (Health and Behavior Assessment/Intervention), A56562.
CMS guidance
The Medicare Learning Network publication that CMS issues on this topic, cited by ICN and publication date:
- Behavioral Health Integration Services(MLN909432, )Behavioral health integration and collaborative care: team members, consent and the billing codes.
Sources
Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.
- HCPCS Level II alpha-numeric file, October 2026Version October 2026 · effective 2026-10-01 · file HCPC2026_OCT_ANWEB_09232026.txtSHA-256 c25240c63108756d…
- Medicare PFS national relative value file RVU26D (non-QPP), October 2026Version RVU26D, released 2026-08-26 · effective 2026-10-01 · file PPRRVU2026_Oct_nonQPP.csvSHA-256 4d0d3f19bd954ffc…
- Medicare PFS national relative value file RVU26D (qualifying APM participants), October 2026Version RVU26D, released 2026-08-26 · effective 2026-10-01 · file PPRRVU2026_Oct_QPP.csvSHA-256 59d3734704853936…
- OPPS Addendum B, October 2026Version October 2026 · effective 2026-10-01 · file 508-compliant-version-2026_October_Web_Addendum_B.09.28.26.csvSHA-256 6ad7393a318bf1b9…
- Integrated Outpatient Code Editor v27.3 data tables: status and payment indicatorsVersion I/OCE v27.3 (October 2026) · effective 2026-10-01 · file Data_Status_Indicator.txtSHA-256 78f119ef0a435351…
- NCCI MUE table, practitioner services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_PractitionerServices_Eff_10-01-2026.csvSHA-256 ef038efaf902b7bd…
- NCCI MUE table, facility services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_OutpatientHospitalServices_Eff_10-01-2026.csvSHA-256 3af9f4e99cc587e2…
- NCCI MUE table, dme services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_DMESupplierServices_Eff_10-01-2026.csvSHA-256 6fa4fbba852f7b74…
- NCCI PTP edits, practitioner, v323r0 (four files)Version v323r0 (2026 Q4) · effective 2026-10-01 · file ccipra-v323r0-f1.TXTSHA-256 7793c0b6686c1e22…
- Medicare Coverage Database, current Billing and Coding Articles exportVersion MCD release 2026-10-08 · effective 2026-10-04 · file article.csvSHA-256 5e95c4a8ac3664be…
- Medicare Coverage Database, current LCD exportVersion MCD release 2026-10-08 · effective 2026-10-04 · file lcd.csvSHA-256 9aee1bd7f14056b0…
Disclaimer
This page is an operational reference compiled from CMS publications: the HCPCS Level II file, the physician, DMEPOS and clinical laboratory fee schedules, OPPS and ASC addenda, NCCI MUE, PTP and add-on edit tables and the Medicare Coverage Database. Amounts are Medicare national figures before locality and state adjustment; Medicaid and commercial payers set their own. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.
Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.