Principal Care Management in Connecticut.
Focused management of a single high-complexity chronic condition. Medicare billing, HUSKY Health coverage, and compliance details for Connecticut providers.
How does PCM work for providers in Connecticut?
Principal Care Management (PCM) allows Connecticut providers to bill Medicare for focused management of a single high-complexity chronic condition using CPT codes 99424, 99425, 99426, 99427. Medicare covers PCM under the same framework as CCM. HUSKY Health provides partial supplementary coverage. Prevalent conditions like heart disease drive PCM demand across Connecticut. CCN Health streamlines PCM workflows including condition-specific care plans, medication management tracking, and automated billing — integrating with 5+ major health systems including Yale New Haven Health and Hartford HealthCare. Connecticut's dense urban healthcare market supports strong adoption of remote care programs.
Medicare Billing
PCM billing in Connecticut.
PCM uses federally standardized CPT codes with uniform reimbursement across Connecticut. HUSKY Health provides partial supplementary Medicaid coverage for dual-eligible patients.
PCM services, first 30 min of clinical staff time per month
Each additional 30 min of PCM clinical staff time
PCM services requiring physician/QHP, first 30 min/month
Each additional 30 min of PCM physician/QHP time
~$75-$115/mo per patient
30 minutes of clinical staff or physician time per month for management of a single high-complexity condition
Medicare covers PCM under the same framework as CCM. HUSKY Health provides partial supplementary coverage.
Billing Requirements
Patient must have a single high-complexity chronic condition
Condition requires frequent medication or treatment adjustment
Cannot be billed simultaneously with CCM (99490/99491)
Comprehensive care plan required for the principal condition
Patient consent required prior to billing
Connecticut Medicaid Supplement
HUSKY Health provides partial supplementary coverage — check current HUSKY Health fee schedules for dual-eligible PCM rates. Connecticut's telehealth parity law supports remote PCM delivery at equivalent reimbursement rates.
Regulatory Landscape
PCM compliance in Connecticut.
Beyond federal Medicare requirements, Connecticut has specific telehealth, licensure, and privacy regulations that affect PCM programs.
Telehealth Parity
- *Connecticut has telehealth parity legislation requiring PCM services to be reimbursed at equivalent rates compared to in-person visits.
- *Connecticut has telehealth parity with comprehensive coverage for remote monitoring. HUSKY Health supports RPM and CCM.
Interstate Licensure
- *Connecticut is not currently a member of the Interstate Medical Licensure Compact. Providers delivering PCM services must hold a valid Connecticut medical license.
EHR Integrations
PCM-compatible EHRs.
Major Connecticut health systems like Yale New Haven Health and Hartford HealthCare use EHR platforms that CCN Health integrates with. Each integration includes automated PCM documentation, billing, and clinical workflows.
PointClickCare
889 integration guides
ALIS
887 integration guides
Ethizo
240 integration guides
athenahealth
240 integration guides
Charm Health
240 integration guides
MatrixCare
240 integration guides
Epic
240 integration guides
August Health
240 integration guides
FAQ
PCM in Connecticut questions.
Connecticut's dense healthcare market and 5+ major health systems like Yale New Haven Health and Hartford HealthCare create strong infrastructure for PCM adoption. HUSKY Health offers partial supplementary coverage for dual-eligible patients. High prevalence of heart disease, diabetes, COPD among Connecticut's patient population drives PCM enrollment.
HUSKY Health provides partial supplementary coverage for PCM services. Medicare covers PCM under the same framework as CCM. HUSKY Health provides partial supplementary coverage. For dual-eligible beneficiaries, providers can bill both Medicare and Medicaid to maximize reimbursement.
Connecticut has telehealth parity legislation requiring PCM services to be reimbursed at equivalent rates compared to in-person visits. Connecticut has telehealth parity with comprehensive coverage for remote monitoring. HUSKY Health supports RPM and CCM.
Among Connecticut's 0.6M seniors, patients with a single high-complexity condition — such as uncontrolled heart disease or advanced diabetes — are prime PCM candidates. Connecticut's urban practices often identify PCM candidates through existing chronic disease registries. Connecticut's high Medicare Advantage penetration means many seniors are already enrolled in plans that support PCM.
Connecticut has approximately 0.6M residents aged 65+ (17.5% of the population), with +12% by 2035 projected growth. Dense population with proximity to NYC. Yale New Haven Health drives clinical innovation. Strong senior living market with above-average income demographics.
PCM in Connecticut must comply with federal Medicare billing requirements and HIPAA. Connecticut does not currently have a comprehensive state privacy law beyond HIPAA, but standard patient consent and data security requirements apply. Connecticut is not part of the Interstate Medical Licensure Compact — providers must hold a valid Connecticut license to deliver PCM services. Connecticut has telehealth parity with comprehensive coverage for remote monitoring. HUSKY Health supports RPM and CCM.
This page provides general informational guidance only and does not constitute legal, compliance, or billing advice. Telehealth regulations, Medicaid coverage, and state privacy laws change frequently. Verify current requirements with your state health department, payers, and qualified healthcare compliance counsel before making program decisions. Demographic data is based on U.S. Census Bureau estimates. Data last verified: March 2026.
Other Programs
More programs in Connecticut.
Explore other Medicare remote care programs available to Connecticut providers.
RPM
Remote Patient Monitoring
Real-time vital sign monitoring with FDA-cleared cellular devices.
CCM
Chronic Care Management
Non-face-to-face care coordination for patients with multiple chronic conditions.
BHI
Behavioral Health Integration
Behavioral health screening and collaborative care in primary care settings.
RTM
Remote Therapeutic Monitoring
Therapy outcome monitoring for musculoskeletal and respiratory rehabilitation.