Principal Care Management

PCM: Specialized Focus for Serious Conditions

  • Bill up to $100/month per eligible patient

  • Manage high-risk patients with one chronic condition

  • Deliver targeted, condition-specific care

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PCM

What Is Principal Care Management (PCM)?

 PCM was created to serve patients with one high-risk chronic condition who may not qualify for CCM but still need structured monthly care.
  • Who is PCM for? PCM is ideal for patients managing a single condition like cancer, COPD, or heart failure that requires intensive oversight and coordination.
  • Why is it great for patients? Patients get focused support for their most pressing health concern, including medication reviews, symptom tracking, and faster care escalation if things worsen.
  • Why is it great for practices? Practices can offer personalized, high-touch care for serious conditions while receiving reimbursement for clinical time spent outside of face-to-face visits.
How It Works (In Plain English)
Your patient has one serious chronic condition—like heart failure, cancer, or COPD.
Each month, your team spends at least 30 minutes managing that condition: checking in, reviewing meds, updating specialists, etc.

Our platform tracks every minute and every task so you're always compliant.

At the end of the month, you bill Medicare and get paid. Perfect for specialists or focused chronic care.
Vitals You Can Monitor
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Principal Care Management Codes

CPT 99424

(

~$80

)

30 Minutes of Provider-Led PCM

Billed monthly when the provider personally spends 30 minutes managing a patient’s single chronic condition (no staff involvement).

CPT 99425

(

~$58

)

Each Additional 30 Minutes of Provider PCM Time

This add-on is billed with 99424 if the provider spends additional time that month on care planning, coordination, or check-ins.

CPT 99426

(

~$61

)

30-Minute Care Coordination by Clinical Staff

This code is billed monthly when clinical staff, under the provider’s supervision, manage care for a patient with one serious chronic condition requiring ongoing attention.

CPT 99427

(

~$50

)

Each Additional 30 Minutes of Staff Time

This is billed in addition to 99426 if staff time exceeds 30 minutes in a given month.

Increase your revenue today

CPT 99424
(
~$80
)
30 Minutes of Provider-Led PCM
Billed monthly when the provider personally spends 30 minutes managing a patient’s single chronic condition (no staff involvement).
CPT 99425
(
~$58
)
Each Additional 30 Minutes of Provider PCM Time
This add-on is billed with 99424 if the provider spends additional time that month on care planning, coordination, or check-ins.
CPT 99426
(
~$61
)
30-Minute Care Coordination by Clinical Staff
This code is billed monthly when clinical staff, under the provider’s supervision, manage care for a patient with one serious chronic condition requiring ongoing attention.
CPT 99427
(
~$50
)
Each Additional 30 Minutes of Staff Time
This is billed in addition to 99426 if staff time exceeds 30 minutes in a given month.
A Nurse taking care of a patient

Why Choose CCN Health?

Instant EHR Integration

Automatically sync patient data directly into your existing workflow—no manual entry required.

Transparent Billing Guidance

Know exactly what CPT codes apply, why they apply, and how to maximize your reimbursements.

Rapid Onboarding

Go from discovery to billing within a single week. No delays, no hassles.

Zero Risk & No Cost

All devices, training, and integration are completely free. You pay nothing upfront.

🚀 6-Step “Quick-Launch” Framework
Understanding the process
01

Discovery Call

We explore your population with high‑risk or severe single chronic conditions and outline an optimized PCM strategy.

02

Sign BAA & Begin Setup

Once the BAA is signed, we configure your PCM workflows, sync your EHR, and prepare condition-specific care plan templates.

03

Identify PCM Candidates & Create Care Plans

We help identify qualifying patients, import their records, and generate focused care plans targeting the principal condition.

04

Launch PCM Management Workflows

Targeted outreach, symptom tracking, medication management, and time documentation go live immediately.

05

Workflow Customization & Team Training

Your team joins a 45‑minute PCM training session covering workflows, escalation paths, and documentation tools.

06

Start Billing With Confidence

View billable PCM minutes and activities instantly, and approve claims directly from your EHR with clear supporting documentation.

Ready to Start?
Schedule your quick, no-obligation discovery call today—and start billing CCM, RPM, RTM, PCM, or BHI within your first 30 days.