🎯PCM

Principal Care Management

Focused chronic care for single high-complexity conditions.

Principal Care Management (PCM) is designed for patients with a single high-risk chronic condition requiring substantial care coordination — such as advanced heart failure, COPD, or uncontrolled diabetes.

Avg. Reimbursement

Up to $45/patient/month

Medicare Part B billable

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CPT Billing Codes

99424

First 30 mins of PCM services, physician/QHP

99425

Each additional 30 mins, physician/QHP

99426

First 30 mins of PCM, clinical staff

99427

Each additional 30 mins, clinical staff

CMS Requirements

✓Single high-complexity chronic condition
✓Condition expected to last ≥3 months
✓Documented care plan specific to that condition
✓Regular monitoring and coordination required

What MedMind Handles

→Condition-specific care plan management
→Specialist communication and referral tracking
→Medication optimization for the primary condition
→Monthly clinical touchpoints and documentation
→Outcome reporting dashboards

Ready to implement PCM?

Our clinical programs team will assess your patient population, estimate revenue potential, and get you enrolled within days.

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Quick Facts

Full Name

Principal Care Management

Abbreviation

PCM

Reimbursement

Up to $45/patient/month

CPT Codes

99424994259942699427

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