PCM · Principal Care Management
Focused management for patients with one serious condition
PCM extends care-between-visits to patients with a single high-risk chronic condition, run by the same CareTrack team and documented in your EHR.
Chronic care management requires two or more chronic conditions, but many of your highest-risk patients have one condition that dominates their care: uncontrolled hypertension, COPD, diabetes, heart failure. Principal Care Management is Medicare's answer, and it's one of the most underused programs in primary and specialty care.
CareTrack runs PCM exactly like our CCM program: eligible patients identified from your panel, condition-specific care plans built with your providers, monthly clinical outreach, and complete documentation in your EHR. For specialists, PCM is often the single fastest path to care-management revenue.
How it works
From panel to program
- 01
Identify
We find patients with a single qualifying high-risk condition expected to last at least 3 months.
- 02
Plan
A disease-specific care plan is created and reviewed with the billing practitioner.
- 03
Manage
Monthly clinical staff time is spent on the condition: adherence, symptoms, escalation when needed.
- 04
Document & bill
Time and interactions are recorded in your EHR against PCM's monthly thresholds.
Reimbursement
PCM CPT codes
The billing framework your practice uses. CareTrack tracks the time and documentation behind every code.
| Code | Description | Billing | 2026 nat’l avg* |
|---|---|---|---|
| 99424 | PCM services by a physician or qualified professional, first 30 minutes per month | Once per month | $87.51 |
| 99425 | Each additional 30 minutes of physician or qualified professional time | Per occurrence | $61.46 |
| 99426 | PCM services by clinical staff, first 30 minutes per month | Once per month | $67.80 |
| 99427 | Each additional 30 minutes of clinical staff time | Up to 2× per month | $54.11 |
Model these rates against your panel with the ROI calculator →
Why practices run it
- Care-management revenue for single-condition patients CCM can't cover
- A natural fit for specialty practices
- Tighter control of the one condition driving the patient's risk
- Same zero-headcount model as CareTrack CCM
Common questions
PCM FAQs
Why should a practice offer a CCM program?
Three reasons: patient health, staff time, and revenue. Regular monthly contact keeps chronic patients consistent with their treatment plans; our care team absorbs the calls and follow-up tasks your staff currently handles unbilled; and the program turns that previously non-billable work into recurring Medicare reimbursement for the practice.
Can CCM be completely delegated to clinical staff?
No. Billing physicians are expected to remain involved in the chronic care management of their enrolled patients. CareTrack operates as clinical staff under your practice's direction: we do the outreach and documentation, your providers stay in charge of the care.
What does CareTrack cost?
Pricing depends on your region's reimbursement rates and your patient mix, so we quote it per practice, typically structured so the program is profitable from the first month. Contact us and we'll model it on your panel's actual numbers.
More questions? See the full FAQ or contact us.
See PCM running on your EHR
A 20-minute walkthrough with your patient panel's numbers, not a canned deck.