Principal Care Management (PCM)
What is Principal Care Management?
Eligibility Requirements:
Patients must have one chronic condition significantly impacting daily life or requiring intensive management.
The condition must be expected to last at least 3–12 months or until death.
PCM services must include a comprehensive care plan tailored to the specific condition.
30 minutes of physician- provided PCM.
CPT Code: 99424
Monthly
Notes on care plan development, time logs, and coordination with other providers.
Additional 30 minutes of physician time.
CPT Code: 99425
Up to 2x per Month.
Supplementary records of extended care activities.
30 minutes of clinical staff time.
CPT Code: 99426
Monthly.
Logs of clinical staff activities, patient communications, and care plan implementation.
Additional 30 minutes of clinical staff time.
CPT Code: 99427
Up to 2x per Month.
Documentation of extended clinical efforts and patient outcomes.
Who can provide the service?
Physicians
Nurse practitioners
Physician assistants
Clinical staff under direct supervision
Potential Benefits:
Focused care for high-risk conditions.
Prevention of complications and hospitalizations.
Improved patient adherence through specialized care plans.
How OnCare360 Can Help:
Customizable care plans for single-condition management.
Time-tracking tools to ensure accurate billing.
Specialty coordination features for seamless collaboration.
Patient engagement tools to enhance adherence.
Compliance monitoring to maintain CMS requirements.
