PCM · Respiratory
Respiratory Monitoring for Home Health PCM — Epic + CCN Health
Respiratory Monitoring technology powering your PCM program in Home Health — fully integrated with Epic. Real-time alerts, clinical workflows, and automated billing in one platform.
Hundreds of facilities just like yours have grown their Principal Care Management programs with CCN Health. .
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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 Home Health.
Tell us about your organization
Share details about your Home Health, 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.
CCN Health provides a certified Principal Care Management (PCM) integration with Epic designed specifically for home health agencies, featuring respiratory monitoring technology. The platform automates clinical documentation, enables real-time monitoring, and generates Medicare billing records for compliant reimbursement.
Respiratory Monitoring for Home Health PCM with Epic
Home Health agencies can enhance their PCM programs with respiratory monitoring technology that integrates directly with Epic. Combination of pulse oximetry (SpO2), respiratory rate tracking via sensorless radar, and spirometry data capture enables comprehensive respiratory monitoring. Peak flow meters and connected spirometers transmit readings automatically to the CCN Health platform.
Why Respiratory Monitoring for Home Health
Home Health agencies serve patients receiving skilled nursing or therapy services in their homes, often managing chronic conditions between agency visits. Respiratory Monitoring is particularly relevant because:
- Multi-sensor approach captures complete respiratory picture
- Combines SpO2, respiratory rate, and airflow measurements
- Early detection of COPD exacerbations before hospitalization
How Respiratory Monitoring Works
Combination of pulse oximetry (SpO2), respiratory rate tracking via sensorless radar, and spirometry data capture enables comprehensive respiratory monitoring. Peak flow meters and connected spirometers transmit readings automatically to the CCN Health platform.
Data Captured
- SpO2 (blood oxygen saturation)
- Respiratory rate
- Peak expiratory flow
- FEV1 trending
- Breathing pattern analysis
Benefits for Home Health Agencies
Between-Visit Monitoring
Continuous data capture fills the gaps between scheduled home visits with objective vital sign data.
Reduced Hospitalizations
Early alerts enable clinical response before conditions require emergency department visits.
Clinician Efficiency
Automated charting reduces documentation burden, allowing clinicians to focus on direct patient care.
Respiratory Monitoring vs. Traditional Approaches
| Factor | Respiratory Monitoring | Traditional |
|---|---|---|
| Scope | SpO2 + RR + spirometry combined | Individual tests at office visits |
| Frequency | Daily monitoring with trending | Quarterly pulmonary function tests |
| Exacerbation Detection | Real-time pattern-based alerts | Patient-reported symptoms |
| Data Integration | All data in one platform | Fragmented across systems |
| Therapy Tracking | Inhaler and treatment compliance | Self-reported adherence |
Common Conditions in Home Health
- heart failure
- COPD
- diabetes
- post-surgical
- wound care
- medication management
Billing & Reimbursement
Respiratory Monitoring data contributes to PCM billing in home health settings:
| 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+
Frequently Asked Questions
Is respiratory monitoring suitable for home health patients?
Yes. Respiratory Monitoring is ideal for home health settings, where multi-sensor approach captures complete respiratory picture.
How does respiratory monitoring data reach Epic?
Data flows automatically from the monitoring system to CCN Health's platform, then syncs bi-directionally with Epic. No manual charting required.
What is the implementation timeline?
Most home health agencies are fully operational within 4 weeks including system deployment, Epic integration, and clinical team training.
Discovery call — we learn your workflows, EHR setup, and patient population so nothing gets lost in translation.
We configure your platform around how your team actually operates — custom alert thresholds, EHR data mapping, and role-based permissions.
Go live with monitoring, automated documentation, and billing tailored to your practice — your team stays focused on care.
No one-size-fits-all templates. Every integration is configured for how your Home Health actually operates.
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 Home Health Facilities Choose CCN Health
Purpose-built technology that fits your clinical workflows and drives measurable outcomes.
Questions?
Want to learn more about Principal Care Management for Home Health?
Our team can answer your questions and show you how it works with your current workflow.
Seamless EHR Integration
How CCN Health Works Inside Epic
Your program data flows directly into Epic — 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.
Epic
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.”
Infrastructure
Devices & Billing
FDA-cleared devices and automated Medicare billing — configured per resident, synced with the EHR.
Medicare Billing
Principal Care Management (PCM)
2 billing codes
First 30 minutes of clinical staff time for PCM
~$70
Monthly
Each additional 30 minutes of PCM clinical staff time
~$54
Monthly (additional)
Common Questions
Frequently Asked Questions
Everything you need to know about implementation, billing, and clinical workflows.
Yes. CCN Health integrates with Epic via secure APIs, enabling RPM device data and care management documentation to flow into Epic's enterprise health records.
CCN Health transmits device readings and care coordination notes to Epic through FHIR-based APIs, ensuring clinical data is available within existing Epic workflows.
PCM focuses on patients with a single high-risk chronic condition, billed under CPT codes 99424 and 99425, covering care coordination and management services.
Home health agencies use RPM to monitor patients between visits, receive real-time alerts for concerning readings, and document care coordination to support billing and compliance.
Respiratory monitoring tracks breathing rate and patterns using connected devices or sensorless technology, enabling early detection of respiratory decline in patients with COPD, asthma, and other pulmonary conditions.
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 Home Health.
Tell us about your organization
Share details about your Home Health, 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.
Get Started
Ready to bring Principal Care Management to your Home Health?
See how CCN Health can improve resident outcomes, preserve independence, support family engagement, and generate new Medicare revenue — all within the EHR your staff already uses.