Principal Care Management.

Management of a single high-risk chronic condition

Focused management of a single high-complexity chronic condition. Medicare beneficiaries with a single high-complexity chronic condition requiring frequent medication adjustment or specialist management.

CardiologyEndocrinologyNephrologyGeriatricsInternal Medicine
PCM program data flow — complete pipelinePCM program data flow — stage 1PCM program data flow — stage 2PCM program data flow — stage 3

764

Integration Guides

7

Monitoring Types

5

Qualifying Conditions

Billing

PCM reimbursement.

Focused management of a single high-complexity chronic condition

CPT CodeServiceReimbursement
99424PCM Services~$70/mo
99425Additional 30 min~$47/mo
99426PCM (Physician)~$83/mo
99427Additional 30 min~$47/mo
Monthly potential per patient~$75–115

Clinical

Qualifying conditions.

01

Uncontrolled Diabetes

E11.65

02

Heart Failure (NYHA III-IV)

I50.x

03

Stage 4-5 CKD

N18.4/N18.5

04

Severe COPD

J44.1

05

Resistant Hypertension

I10

Patient Criteria

Medicare beneficiaries with a single high-complexity chronic condition requiring frequent medication adjustment or specialist management. Cannot be billed concurrently with CCM for the same patient.

Advantages

Key benefits.

Higher per-patient revenue than CCM

Only one qualifying condition needed

Specialist-focused care management

Ideal for complex condition subtypes

Monitoring

Compatible devices.

Blood Pressure

BP monitoring with FDA-cleared devices

Weight

Weight monitoring with connected scales

Blood Glucose

Blood glucose meters for diabetes

CGM

Continuous glucose monitoring (Dexcom)

Pulse Oximetry

SpO2 and heart rate

Sensorless Monitoring

Contactless radar-based monitoring (Xandar Kardian)

Respiratory

Respiratory rate monitoring

Questions?

Want to learn more about PCM for your practice?

Our team can answer your questions and show you how it works with your current workflow.

Integration Guides

PCM articles.

764 articles

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.

Ready to Get Started?

Let’s design your PCM program.

Book a short discovery call and we’ll map out a program tailored to your workflows, EHR, and patient population.

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More to explore.

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Blog

Glossary

Comparisons

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