athenahealth Integration
Principal Care Management with CCN Health's athenahealth Integration
How CCN Health delivers Principal Care Management through seamless athenahealth integration — automated documentation, real-time alerts, and Medicare billing built in.
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Not ready for a call? No problem. Drop us a message and we'll get back to you within 24 hours with answers to your questions about Principal Care Management for your facility.
Tell us about your organization
Share details about your facility, current EHR setup, and what you're looking to achieve.
We'll review and respond
Our team will assess your needs and send you relevant information, case studies, or suggest next steps.
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When the time is right, we'll schedule a personalized demo tailored to your workflows.
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CCN Health provides a certified Principal Care Management (PCM) integration with athenahealth. The platform automates clinical documentation, enables real-time monitoring, and generates Medicare billing records for compliant reimbursement.
What is Principal Care Management with athenahealth?
With CCN Health's athenahealth integration, PCM programs become operationally simple. Vital sign data, clinical alerts, and care documentation flow automatically between systems.
Focused management of a single high-complexity chronic condition that requires frequent specialist-level attention. Ideal for conditions like advanced heart failure, complex diabetes, or stage 4+ CKD.
How It Works
- Condition Identification — Identify a single high-complexity chronic condition requiring ongoing management
- Specialist Care Plan — Develop condition-specific management plan with measurable goals
- Focused Monitoring — Disease-specific metrics tracked and trended over time
- athenahealth Integration — Specialist coordination data and care plans sync with athenahealth automatically
- Billing Automation — Time tracking for CPT 99424-99427 documented automatically
Key Features
| Feature | Details |
|---|---|
| EHR Integration | Bi-directional sync with athenahealth |
| Devices Supported | Blood pressure, weight, SpO2, glucose, sensorless |
| Alert Time | Real-time notifications to care staff |
| Billing Codes | 99424, 99425, 99426, 99427 |
| Compliance | HIPAA compliant, CMS-aligned documentation |
| Platform Uptime | 99.9% availability |
High-Complexity Conditions for PCM
| Condition | Key Metrics | Monitoring Approach |
|---|---|---|
| Advanced heart failure (NYHA III-IV) | Daily weight, BP, heart rate | Weight scale, BP monitor |
| Insulin-dependent diabetes | Glucose trends, A1c trajectory | CGM or glucose meter |
| Stage 4+ CKD | Weight, BP, fluid status | Weight scale, BP monitor |
| Advanced COPD (GOLD III-IV) | SpO2, respiratory rate | Pulse oximeter |
| Complex pain syndromes | Pain scores, medication adherence | Digital self-reporting |
Clinical Benefits
- Intensive management of high-risk conditions
- Reduced ER visits through specialist-level oversight
- Measurable improvement in disease-specific outcomes
- Better coordination between primary and specialty care
Billing & Reimbursement
CCN Health automates Medicare PCM billing documentation:
| CPT Code | Reimbursement | Requirements |
|---|---|---|
| 99424 | ~$70/mo | 30+ minutes of clinical staff time per month |
| 99425 | ~$56/mo | Each additional 30 minutes of clinical time |
| 99426 | ~$80/mo | 30+ minutes of physician/QHP time |
| 99427 | ~$64/mo | Each additional 30 minutes of physician time |
Monthly potential per patient: $70+
Ready to Get Started?
CCN Health handles everything — athenahealth integration setup, condition-specific care plans, staff training, and ongoing clinical support. Most practices are fully operational within 2-4 weeks.
Frequently Asked Questions
Does CCN Health integrate directly with athenahealth for PCM?
Yes. CCN Health has a certified integration with athenahealth that enables bi-directional data flow. Vital signs and clinical data automatically appear in athenahealth patient records.
What are the billing requirements for PCM?
99424 requires 30+ minutes of clinical staff time per month. CCN Health tracks all requirements automatically and generates documentation for compliant billing.
Can PCM data be used across other programs?
Yes. CCN Health's platform enables cross-program data sharing. PCM data is available for use in RPM, CCM, PCM, and BHI programs without re-entry.
Configurable Alerts
Set thresholds that match your clinical protocols
Flexible Workflows
Adapt routing, documentation, and permissions to your team
Automated Compliance
Real-time audit trail and billing validation
Advanced technology working behind the scenes — so your team gets faster processing, smarter alerts, and effortless documentation without changing how they work.


Technology that stays in the background — so care stays in the foreground.
Why CCN Health
Why Healthcare Organizations Choose CCN Health
Purpose-built technology that fits your clinical workflows and drives measurable outcomes.
EHR Integration
Bi-directional data sync with your existing EHR eliminates manual charting and reduces documentation errors.
Revenue Generation
Automated Medicare billing documentation captures every eligible reimbursement opportunity.
Clinical Outcomes
Real-time alerts and trending data enable early intervention before conditions deteriorate.
Built-In Efficiency
Automated workflows handle documentation, threshold management, and billing preparation — freeing clinical staff for direct patient care.
Family Engagement
Proactive monitoring gives families confidence in the quality of care being delivered.
Compliance & Reporting
Timestamped documentation supports regulatory compliance and quality measure reporting.
Questions?
Want to learn more about Principal Care Management for your facility?
Our team can answer your questions and show you how it works with your current workflow.
Seamless EHR Integration
How CCN Health Works Inside athenahealth
Your program data flows directly into athenahealth — no exports, no manual entry, no disruption to your clinical workflow.
Specialist Data
Condition Monitoring, Referrals
Built Around How You Operate
Custom workflows, smart alerting, and automated documentation — advanced technology working behind the scenes so your team doesn't have to.
athenahealth
Charts & Care Plans
What Flows Between Systems
Patient Demographics
High-risk conditions, specialist data, and medications
Condition Tracking
Disease-specific metrics monitored and trended
Specialist Coordination
Referral data and specialist notes synchronized
Care Plans
Condition-specific treatment plans inform monitoring
Time Tracking
Care management minutes tracked for billing compliance
Billing Documentation
CPT 99424/99425/99426/99427 records generated automatically
“Every reading, every alert, every care plan update — available across all your programs. One integration, unlimited use cases.”
Common Questions
Frequently Asked Questions
Everything you need to know about Principal Care Management — implementation, billing, and clinical workflows.
Yes. CCN Health integrates with athenahealth so that RPM data flows directly into patient charts, reducing manual documentation and improving care coordination.
PCM focuses on patients with a single high-risk chronic condition, billed under CPT codes 99424 and 99425, covering care coordination and management services.
Most facilities are fully operational within 2–4 weeks. CCN Health handles device provisioning, EHR integration setup, staff training, and ongoing clinical support.
Still have questions? We're happy to walk you through anything.
Contact Us
Prefer to Send a Message?
Not ready for a call? No problem. Drop us a message and we'll get back to you within 24 hours with answers to your questions about Principal Care Management for your facility.
Tell us about your organization
Share details about your facility, current EHR setup, and what you're looking to achieve.
We'll review and respond
Our team will assess your needs and send you relevant information, case studies, or suggest next steps.
Connect when you're ready
When the time is right, we'll schedule a personalized demo tailored to your workflows.
Send Us a Message
We'll get back to you within 24 hours.

