In these days’s healthcare landscape, chronic disease management is essential to making better patients. Principal Care Management (PCM) is designed to assist carriers manage sufferers with single, excessive-danger chronic situations. Whether you’re handling patients with severe bronchial asthma, diabetes, or coronary heart failure, PCM permits committed care and a common communique to keep away from hospitalization and functional decline.
Principal Care Management (PCM) is a healthcare model developed to cater to patients with a single chronic condition that has lasted for at least three months. According to the Centers for Medicare and Medicaid Services (CMS), PCM focuses on dealing with conditions that place patients at a high risk of:
PCM offers a personalized approach to care, where physicians or clinical staff develop tailored care plans, provide regular check-ins, and make timely adjustments to medication regimens. This comprehensive care helps stabilize the patient before they are transitioned to a primary care provider or continue regular disease management.
In 2024, CMS introduced 4 new CPT codes for Principal Care Management, which changed the previous HCPCS Level II codes G2064 and G2065. These codes permit companies to bill for the time they spend dealing with a single excessive-danger situation.
The four PCM codes include:
While PCM and Chronic Care Management (CCM) services are both imperative to continual sickness care, they fluctuate in numerous methods:
Understanding these differences is essential for accurate billing and ensuring the best care for your patients.
Our goal is to streamline your healthcare revenue cycle management, give you the financial freedom your practice deserves, and take control with a partner specializing in provider RCM optimization and services excellence.
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Just like any care management service, PCM requires detailed documentation to comply with CMS medical billing rules. The following information must be recorded:
By keeping these records, you can ensure proper reimbursement and maintain high-quality patient care.
Implement PCM in your practice is not only about improving patient outcomes but also offers a new revenue stream for billing practitioners. With the right systems and support, healthcare providers can efficiently manage high-risk patients, increase engagement, and secure more consistent reimbursements through PCM billing.
At Cures MB, we specialize in helping providers navigate the complexities of PCM billing. Our team ensures you get the most out of Medicare’s reimbursement opportunities while focusing on delivering the best care to your patients.
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We are a team of national medical billing service experts based in Astoria, NY, committed to providing ongoing value to our customers. We leverage technology and implement best practices to provide high-quality and cost-efficient medical billing solutions from domestic locations, enabling customers to achieve their business goals. Cures Medical Billing is the best option for any medical billing needs.
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