Principal Care Management

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Principal Care Management

Principal Care Management (PCM) at Central Health Solutions

Providing targeted treatment and support for patients with a single chronic illness, Principal Care Management (PCM) at Central Health Solutions ensures personalized, proactive care. Our goal is to help patients manage their condition, prevent health deterioration, and enhance their overall well-being.

Managing Chronic Conditions with Central Health Solutions

Nearly half of the U.S. population suffers from at least one chronic condition. PCM services are designed to deliver focused, high-quality care to these patients, emphasizing stability and prevention of exacerbations.

  • 47% of the U.S. population lives with a chronic condition.
  • 7 out of 10 deaths in the U.S. are linked to chronic diseases, accounting for over 1.7 million fatalities annually.

User-Friendly Portal for Clinicians

Central Health Solutions simplifies the management of chronic care. Our clinician-friendly portal automates workflows, easing the burden on healthcare staff and reducing burnout. The platform enhances care with robust tools for monitoring various conditions, including respiratory and musculoskeletal health, while ensuring therapy adherence.

Security, Compliance, and Clinical Decision Support

Central Health Solutions ensures all services adhere to HIPAA compliance, including secure SMS and in-app communications. Our platform enhances clinical decision support by leveraging integrated patient data to provide real-time insights for better patient management.

Concurrent Billing with Remote Patient Monitoring (RPM) and Chronic Care Management (CCM)

Providers can manage RPM, CCM, and PCM concurrently, allowing for efficient, streamlined billing and service delivery without duplicating time entries.

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Ready to Improve Patient Outcomes with PCM

Contact Central Health Solutions to explore how our Principal Care Management platform can benefit your practice and patients.

Associated CPT Codes for

Principal Care Management (PCM)

CPT Code 99424

First 30 minutes of PCM provided by a physician or qualified healthcare professional.

Average payment – $97

CPT Code 99425

Each additional 30 minutes of service is billed with 99424 for accurate reimbursement.

Average payment – $71

CPT Code 99427

Additional 30 minutes of PCM clinical staff time required for patient care support.

Average payment – $57

Note: Payments may vary by location. Please refer to cms.gov for more details.

Frequently Asked Questions

Fundamentally, principal care management is a model for the care of patients with a chronic illness for a period lasting three or more months. According to the CMS definition (via the AACP), the patient must also have had either a recent hospitalization or an acute risk of death, exacerbation or functional decline, or require management that’s “unusually complex due to comorbidities.”

Principal Care Management (PCM) utilizes CPT codes 99424 and 99425 for the physician’s or non-physician practitioner’s (NPP’s) initial 30 minutes and additional 30 minutes, respectively. It also employs CPT codes 99426 and 99427 to document and bill for the clinical staff’s initial 30 minutes and each additional 30-minute increment, respectively, dedicated to supporting patients with specific chronic conditions.

These codes facilitate meticulous tracking of patient care, ensuring that individuals receive personalized attention and comprehensive management to effectively navigate their health challenges.

The key requirements include:

  • Checking patients’ eligibility for PCM and receiving patient consents.
  • Patients need a single, serious, and complex chronic condition.
  • Providers/Clinical Staff meet monthly time thresholds (30 minutes and additional 30 minutes), documenting care plans and staff involvement.
  • Accurate coding and detailed documentation are essential.