Principal Care Management is also known as PCM and it is very similar to Medicare’s Chronic Care Management (CCM) with a few key differences. Under the new PCM codes, specialists may now be reimbursed for providing their patients with care management services that are more targeted within their own particular area of specialty. This program addresses the need for classification of treatment for patients with one chronic condition.

HCPCS Codes and Descriptors

  • CPT Code
  • Billing Code Descriptors
  • Duration
  • Average Reimbursement

  • HCPCS Code

    99424

  • Billing Code Descriptors

    PCM service provided by Physician

  • Duration

    30 minutes

  • Average Reimbursement

    $81

  • HCPCS Code

    99425

  • Billing Code Descriptors

    Add-on Code for service provided by Physician

  • Duration

    30 minutes

  • Average Reimbursement

    $58

  • HCPCS Code

    99426

  • Billing Code Descriptors

    PCM service provided by Clinical Staff

  • Duration

    30 minutes

  • Average Reimbursement

    $61

  • HCPCS Code

    99427

  • Billing Code Descriptors

    Add-on Code for service provided by Clinical Staff

  • Duration

    30 minutes

  • Average Reimbursement

    $47