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CareTrack

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

  1. 01

    Identify

    We find patients with a single qualifying high-risk condition expected to last at least 3 months.

  2. 02

    Plan

    A disease-specific care plan is created and reviewed with the billing practitioner.

  3. 03

    Manage

    Monthly clinical staff time is spent on the condition: adherence, symptoms, escalation when needed.

  4. 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.

CodeDescription2026 nat’l avg*
99424PCM services by a physician or qualified professional, first 30 minutes per month$87.51
99425Each additional 30 minutes of physician or qualified professional time$61.46
99426PCM services by clinical staff, first 30 minutes per month$67.80
99427Each additional 30 minutes of clinical staff time$54.11
PCM and CCM cannot be billed for the same patient in the same month. We manage program assignment across your panel so every patient is in the right program. *Approximate 2026 national non-facility Medicare amounts. Actual payment varies by locality, site of service, and payer; verify with the CMS Physician Fee Schedule look-up tool.

Model these rates against your panel with the ROI calculator →

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Qualifying condition · vs. 2+ required for CCM
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Month minimum expected duration of the condition
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Patient retention rate across CareTrack programs

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

See it in practice: Cedar Point Health

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.

Book a demo