Group: PCM

Billing Codes

99424 99425– Principal care management services, for a single highrisk disease physician or other qualified health care professional, per calendar.

What documentation is required?

In addition to time, the provider/clinical staff must document the following required elements, per CPT: One complex chronic condition expected.

What are the requirements for patient qualification?

The qualifying condition for reporting PCM codes would be a patient with one serious chronic condition, typically expected to last.