PCM Eligibility Requirements
PCM focuses on intensive management of a single high-risk chronic condition expected to last at least 3 months. It is designed for patients where one dominant condition drives the majority of care needs and places the patient at significant risk of hospitalization or functional decline.
PCM Diagnoses
All qualifying ICD-10 codes.
84 ICD-10 codes qualify patients for Principal Care Management. Filter by specialty or category, or search by code.
By Specialty
PCM codes by medical specialty.
FAQ
PCM eligibility questions.
What ICD-10 codes qualify patients for PCM?
PCM (Principal Care Management) qualifying diagnoses are listed in the directory below. Patients need one high-risk chronic condition expected to last at least 3 months.
How does CCN Health help with PCM patient eligibility?
CCN Health reviews your patient population to identify qualifying diagnoses, handles enrollment documentation, and manages ongoing PCM services including clinical monitoring, care coordination, and Medicare billing — typically launching within 1 week.
Can PCM be billed alongside other Medicare programs?
PCM cannot be billed with CCM in the same month. However, PCM can be billed alongside RPM, BHI, and RTM.