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Principal Care Management

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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.

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.

Complete Principal Care Management Services

Central Health Solutions simplifies the management of chronic care with a platform built for both clinicians and patients — combining automation, real-time insight, and full compliance in one place.

Why Providers Choose Central Health Solutions

Our PCM platform is built to make chronic condition management easier for your practice and better for your patients — backed by data, compliance, and a workflow designed to reduce administrative strain.

Addresses a Widespread Need

47% of the U.S. population lives with a chronic condition.

Tackles a Leading Cause of Death

7 out of 10 deaths in the U.S. are linked to chronic diseases, accounting for over 1.7 million fatalities annually.

Reduced Clinician Burnout

Automates workflows, easing the burden on healthcare staff and reducing burnout.

Prevents Health Deterioration

Helps patients manage their condition and prevent health deterioration.

Enhanced Patient Well-Being

Enhances patients' overall well-being through proactive, personalized care.

Streamlined Eligibility & Consent

Checking patients' eligibility for PCM and receiving patient consents is built into the process.

Clear Documentation Standards

Providers and clinical staff meet monthly time thresholds, documenting care plans and staff involvement, with accurate coding and detailed documentation.

No Duplicate Time Entries

Manage RPM, CCM, and PCM concurrently without duplicating time entries.

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 by

Associated CPT Codes for Principal Care Management

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.