Principal Care Management in Kansas.

Focused management of a single high-complexity chronic condition. Medicare billing, KanCare coverage, and compliance details for Kansas providers.

0.5M seniors (65+)
Verify telehealth regulations
KanCare: Partial coverage
Quick Answer

How does PCM work for providers in Kansas?

Principal Care Management (PCM) allows Kansas 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. KanCare provides partial supplementary coverage. Prevalent conditions like heart disease drive PCM demand across Kansas. CCN Health streamlines PCM workflows including condition-specific care plans, medication management tracking, and automated billing — integrating with 5+ major health systems including University of Kansas Health System and Ascension Via Christi.

Medicare Billing

PCM billing in Kansas.

PCM uses federally standardized CPT codes with uniform reimbursement across Kansas. KanCare provides partial supplementary Medicaid coverage for dual-eligible patients.

99424~$70

PCM services, first 30 min of clinical staff time per month

99425~$55

Each additional 30 min of PCM clinical staff time

99426~$85

PCM services requiring physician/QHP, first 30 min/month

99427~$65

Each additional 30 min of PCM physician/QHP time

Revenue Range

~$75-$115/mo per patient

Time Threshold

30 minutes of clinical staff or physician time per month for management of a single high-complexity condition

KanCare
Partial coverage

Medicare covers PCM under the same framework as CCM. KanCare 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

Kansas Medicaid Supplement

KanCare: Partial coverage

KanCare provides partial supplementary coverage — check current KanCare fee schedules for dual-eligible PCM rates.

Regulatory Landscape

PCM compliance in Kansas.

Beyond federal Medicare requirements, Kansas has specific telehealth, licensure, and privacy regulations that affect PCM programs.

01

Interstate Licensure

  • *Kansas is a member of the Interstate Medical Licensure Compact, enabling physicians licensed through the compact to provide PCM services across state lines.

Market Opportunity

PCM in Kansas.

0.5M

seniors 65+ (16% of population)

+14% 2035

projected growth (Census Bureau est.)

5+

major health systems

Large rural areas benefit from remote monitoring. Kansas City and Wichita have strong healthcare infrastructure. University of Kansas Health System drives innovation.

University of Kansas Health SystemAscension Via ChristiStormont Vail HealthAdventHealth KansasWesley Healthcare

EHR Integrations

PCM-compatible EHRs.

Major Kansas health systems like University of Kansas Health System and Ascension Via Christi use EHR platforms that CCN Health integrates with. Each integration includes automated PCM documentation, billing, and clinical workflows.

How CCN Health Helps

From setup to scale.

01

Discovery & Setup

We learn your workflows, EHR configuration, and patient population — then configure CCN’s platform to match.

02

Launch & Monitor

Devices ship directly to patients, data flows into your EHR automatically, and our clinical team monitors around the clock.

03

Scale & Optimize

Expand enrollment, add new programs, and let AI-driven insights continuously improve outcomes and reimbursement.

FAQ

PCM in Kansas questions.

Kansas's mix of urban centers and rural communities means PCM serves both high-volume practices affiliated with systems like University of Kansas Health System and Ascension Via Christi and remote clinics where in-person visits are difficult. KanCare offers partial supplementary coverage for dual-eligible patients. Kansas's membership in the Interstate Medical Licensure Compact enables cross-state PCM delivery. High prevalence of heart disease, diabetes, COPD among Kansas's patient population drives PCM enrollment.

KanCare provides partial supplementary coverage for PCM services. Medicare covers PCM under the same framework as CCM. KanCare provides partial supplementary coverage. For dual-eligible beneficiaries, providers can bill both Medicare and Medicaid to maximize reimbursement.

Among Kansas's 0.5M seniors, patients with a single high-complexity condition — such as uncontrolled heart disease or advanced diabetes — are prime PCM candidates. Kansas's urban practices often identify PCM candidates through existing chronic disease registries.

Kansas has approximately 0.5M residents aged 65+ (16% of the population), with +14% by 2035 projected growth. Large rural areas benefit from remote monitoring. Kansas City and Wichita have strong healthcare infrastructure. University of Kansas Health System drives innovation.

PCM in Kansas must comply with federal Medicare billing requirements and HIPAA. Kansas does not currently have a comprehensive state privacy law beyond HIPAA, but standard patient consent and data security requirements apply. As an Interstate Medical Licensure Compact member, Kansas allows compact-licensed physicians to deliver PCM services across state lines. Kansas has telehealth parity. KanCare managed care organizations cover RPM and CCM services.

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.

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