PCM · Physical Medicine & Rehab
PCM Qualifying Diagnoses
for Physical Medicine & Rehab.
66 ICD-10-CM codes cover physical medicine & rehab patients for Principal Care Management (PCM).
Qualifying Codes
ICD-10 codes for physical medicine & rehab.
Neurologic and cognitive
Parkinson's disease and secondary parkinsonism
G20, G21, G23, G24, G2545 codesccmpcmrtmGait, activity and fall detection, with therapy adherence tracked under RTM.
Parkinson's disease and secondary parkinsonism
G20, G21, G23, G24, G2545 codesccmpcmrtmCMS chronic condition · CCW category: Parkinson's Disease and Secondary Parkinsonism · Devices: Contactless activity and fall radar, Patient-reported outcome app (RTM)
G20 alone is no longer valid. Code to G20.A1, G20.A2, G20.B1, G20.B2 or G20.C.
| Code | Official ICD-10-CM description | Programs | Risk adjustment |
|---|---|---|---|
| G20.A1 | Parkinson's disease without dyskinesia, without mention of fluctuations | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G20.A2 | Parkinson's disease without dyskinesia, with fluctuations | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G20.B1 | Parkinson's disease with dyskinesia, without mention of fluctuations | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G20.B2 | Parkinson's disease with dyskinesia, with fluctuations | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G20.C | Parkinsonism, unspecified | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G21.0 | Malignant neuroleptic syndrome | ccmpcmrtm | not risk adjusted |
| G21.11 | Neuroleptic induced parkinsonism | ccmpcmrtm | not risk adjusted |
| G21.19 | Other drug induced secondary parkinsonism | ccmpcmrtm | not risk adjusted |
| G21.2 | Secondary parkinsonism due to other external agents | ccmpcmrtm | not risk adjusted |
| G21.3 | Postencephalitic parkinsonism | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G21.4 | Vascular parkinsonism | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G21.8 | Other secondary parkinsonism | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G21.9 | Secondary parkinsonism, unspecified | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G23.0 | Hallervorden-Spatz disease | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G23.1 | Progressive supranuclear ophthalmoplegia [Steele-Richardson-Olszewski] | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G23.2 | Striatonigral degeneration | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G23.3 | Hypomyelination with atrophy of the basal ganglia and cerebellum | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G23.8 | Other specified degenerative diseases of basal ganglia | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G23.9 | Degenerative disease of basal ganglia, unspecified | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G24.01 | Drug induced subacute dyskinesia | ccmpcmrtm | not risk adjusted |
| G24.02 | Drug induced acute dystonia | ccmpcmrtm | not risk adjusted |
| G24.09 | Other drug induced dystonia | ccmpcmrtm | not risk adjusted |
| G24.1 | Genetic torsion dystonia | ccmpcmrtm | not risk adjusted |
| G24.2 | Idiopathic nonfamilial dystonia | ccmpcmrtm | not risk adjusted |
| G24.3 | Spasmodic torticollis | ccmpcmrtm | not risk adjusted |
| G24.4 | Idiopathic orofacial dystonia | ccmpcmrtm | not risk adjusted |
| G24.5 | Blepharospasm | ccmpcmrtm | not risk adjusted |
| G24.8 | Other dystonia | ccmpcmrtm | not risk adjusted |
| G24.9 | Dystonia, unspecified | ccmpcmrtm | not risk adjusted |
| G25.0 | Essential tremor | ccmpcmrtm | not risk adjusted |
| G25.1 | Drug-induced tremor | ccmpcmrtm | not risk adjusted |
| G25.2 | Other specified forms of tremor | ccmpcmrtm | not risk adjusted |
| G25.3 | Myoclonus | ccmpcmrtm | not risk adjusted |
| G25.4 | Drug-induced chorea | ccmpcmrtm | not risk adjusted |
| G25.5 | Other chorea | ccmpcmrtm | not risk adjusted |
| G25.61 | Drug induced tics | ccmpcmrtm | not risk adjusted |
| G25.69 | Other tics of organic origin | ccmpcmrtm | not risk adjusted |
| G25.70 | Drug induced movement disorder, unspecified | ccmpcmrtm | not risk adjusted |
| G25.71 | Drug induced akathisia | ccmpcmrtm | not risk adjusted |
| G25.79 | Other drug induced movement disorders | ccmpcmrtm | not risk adjusted |
| G25.81 | Restless legs syndrome | ccmpcmrtm | not risk adjusted |
| G25.82 | Stiff-man syndrome | ccmpcmrtm | not risk adjusted |
| G25.83 | Benign shuddering attacks | ccmpcmrtm | not risk adjusted |
| G25.89 | Other specified extrapyramidal and movement disorders | ccmpcmrtm | not risk adjusted |
| G25.9 | Extrapyramidal and movement disorder, unspecified | ccmpcmrtm | not risk adjusted |
Multiple sclerosis and demyelinating disease
G35, G36, G3721 codesccmpcmrtmFunction and fatigue tracking, with therapy adherence under RTM.
Multiple sclerosis and demyelinating disease
G35, G36, G3721 codesccmpcmrtmCMS other chronic or potentially disabling condition · CCW category: Multiple Sclerosis and Transverse Myelitis · Devices: Patient-reported outcome app (RTM), Contactless activity and fall radar
G35 alone is no longer valid as of FY2026. Code to G35.A through G35.D.
| Code | Official ICD-10-CM description | Programs | Risk adjustment |
|---|---|---|---|
| G35.A | Relapsing-remitting multiple sclerosis | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G35.B0 | Primary progressive multiple sclerosis, unspecified | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G35.B1 | Active primary progressive multiple sclerosis | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G35.B2 | Non-active primary progressive multiple sclerosis | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G35.C0 | Secondary progressive multiple sclerosis, unspecified | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G35.C1 | Active secondary progressive multiple sclerosis | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G35.C2 | Non-active secondary progressive multiple sclerosis | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G35.D | Multiple sclerosis, unspecified | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G36.0 | Neuromyelitis optica [Devic] | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G36.1 | Acute and subacute hemorrhagic leukoencephalitis [Hurst] | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G36.8 | Other specified acute disseminated demyelination | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G36.9 | Acute disseminated demyelination, unspecified | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G37.0 | Diffuse sclerosis of central nervous system | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G37.1 | Central demyelination of corpus callosum | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G37.2 | Central pontine myelinolysis | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G37.3 | Acute transverse myelitis in demyelinating disease of central nervous system | ccmpcmrtm | HCC 182 · Spinal Cord Disorders/Injuries |
| G37.4 | Subacute necrotizing myelitis of central nervous system | ccmpcmrtm | HCC 182 · Spinal Cord Disorders/Injuries |
| G37.5 | Concentric sclerosis [Balo] of central nervous system | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G37.81 | Myelin oligodendrocyte glycoprotein antibody disease | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G37.89 | Other specified demyelinating diseases of central nervous system | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G37.9 | Demyelinating disease of central nervous system, unspecified | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
Polyneuropathy and nerve disorders
G54, G56, G57, G58, G59, G60, G61, G62, G63, G64, G65107 codes in familyccmpcmrtmPain and function scores, most often alongside diabetes management.
Polyneuropathy and nerve disorders
G54, G56, G57, G58, G59, G60, G61, G62, G63, G64, G65107 codes in familyccmpcmrtmAdded by CCN Health · Devices: Patient-reported outcome app (RTM)
This family runs to 107 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within G54, G56, G57, G58, G59, G60, G61, G62, G63, G64, G65.
Paralysis, cerebral palsy and spinal cord injury
G80, G81, G82, G83, G9562 codes in familyccmpcmrtmFunction, mobility and pressure-injury surveillance.
Paralysis, cerebral palsy and spinal cord injury
G80, G81, G82, G83, G9562 codes in familyccmpcmrtmCMS other chronic or potentially disabling condition · CCW category: Cerebral Palsy · Devices: Contactless activity and fall radar, Patient-reported outcome app (RTM)
This family runs to 62 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within G80, G81, G82, G83, G95.
Traumatic brain injury sequelae
F06, F07, G93.1, G93.424 codes in familyccmbhipcmCognitive and behavioural follow-up with structured instruments.
Traumatic brain injury sequelae
F06, F07, G93.1, G93.424 codes in familyccmbhipcmCMS other chronic or potentially disabling condition · CCW category: Traumatic Brain Injury and Nonpsychotic Mental Disorders due to Brain Damage · Devices: Patient-reported outcome app (RTM)
This family runs to 24 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within F06, F07, G93.1, G93.4.
Muscular dystrophy and myopathies
G71, G72, G7340 codes in familyccmpcmrtmFunction tracking, with respiratory surveillance where the diaphragm is involved.
Muscular dystrophy and myopathies
G71, G72, G7340 codes in familyccmpcmrtmCMS other chronic or potentially disabling condition · CCW category: Muscular Dystrophy · Devices: Patient-reported outcome app (RTM), Pulse oximeter
This family runs to 40 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within G71, G72, G73.
Musculoskeletal and pain
Rheumatoid and inflammatory arthritis
M05, M06, M08, M12, M13, M45, M46743 codes in familyrtmccmpcmDisease-activity scores, function and therapy adherence.
Rheumatoid and inflammatory arthritis
M05, M06, M08, M12, M13, M45, M46743 codes in familyrtmccmpcmCMS chronic condition · CCW category: Rheumatoid Arthritis/Osteoarthritis · Devices: Patient-reported outcome app (RTM)
This family runs to 743 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within M05, M06, M08, M12, M13, M45, M46.
Other chronic and potentially disabling
Pressure ulcers and chronic ulcers
L89, L97, L98.4407 codes in familyccmpcmrtmRepositioning and mobility surveillance alongside structured wound assessment.
Pressure ulcers and chronic ulcers
L89, L97, L98.4407 codes in familyccmpcmrtmCMS other chronic or potentially disabling condition · CCW category: Pressure Ulcers and Chronic Ulcers · Devices: Contactless activity and fall radar
This family runs to 407 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within L89, L97, L98.4.
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Clinical Context
Why physical medicine & rehab practices benefit from PCM.
Physical Medicine & Rehab practices can leverage PCM to improve patient outcomes through structured care management, generating $97–$220+ per patient per month in Medicare reimbursement while reducing avoidable hospitalizations.
FAQ
Common questions.
What ICD-10 codes qualify physical medicine & rehab patients for PCM?
CMS publishes no list of codes that qualify a patient for PCM: eligibility turns on the condition and on documented medical necessity. For physical medicine & rehab, 66 billable ICD-10-CM codes cover the conditions PCM manages, spanning 8 conditions including parkinson's disease and secondary parkinsonism, multiple sclerosis and demyelinating disease, polyneuropathy and nerve disorders, paralysis, cerebral palsy and spinal cord injury, traumatic brain injury sequelae, muscular dystrophy and myopathies.
How does CCN Health support physical medicine & rehab practices with PCM?
CCN Health provides turnkey PCM services for physical medicine & rehab practices, including patient eligibility identification, enrollment documentation, device provisioning, clinical monitoring, and full Medicare billing support.
What is the revenue potential for PCM in physical medicine & rehab?
Reimbursement varies by locality and payer contract, so see the PCM billing guide for current figures. Physical Medicine & Rehab practices with a high prevalence of these conditions generally see the most benefit, particularly when PCM is combined with RPM and BHI for patients whose needs are distinct enough to document separately.
Sources & Compliance
Code set. Every code on this page is drawn from the official ICD-10-CM ICD-10-CM FY2026 (valid 2025-10-01 through 2026-09-30) released by CDC/NCHS, and only codes flagged valid for submission are listed. ICD-10-CM is published by the federal government and is in the public domain, so the descriptions here are the official long descriptors reproduced verbatim rather than summarized. The next code set, ICD-10-CM FY2027 (valid from 2026-10-01), is already reflected in the change flags.
Eligibility is not a code list. CMS does not publish a list of ICD-10 codes that qualify a patient for RPM, CCM, PCM, BHI, or RTM. Eligibility turns on the condition and on documented medical necessity. The programs shown against each condition are CCN Health’s clinical assessment of which programs that condition can support, not a statement of CMS approval.
Risk adjustment. HCC labels and category assignments come from the CMS-HCC V28 model for the 2026 payment year. Risk adjustment depends on the full encounter record, not on a single code, and the flags here are a prompt to check specificity rather than a payment guarantee.
CPT® notice. CPT is a registered trademark of the American Medical Association. CPT codes, descriptions, and other data only are copyright 2026 American Medical Association. All rights reserved. CPT is provided “as is” without warranty of any kind.
Sources. ICD-10-CM files, CDC/NCHS (cdc.gov); CMS Chronic Conditions Data Warehouse condition categories (ccwdata.org); CMS-HCC risk adjustment model software and ICD-10 mappings (cms.gov); AHRQ Clinical Classifications Software Refined (ahrq.gov).
Disclaimer. This page is informational and does not constitute billing, clinical, or legal advice. Diagnosis coding must reflect the documentation in the medical record. Verify all codes against the official CMS and CDC/NCHS publications and your contracted payer agreements before billing.