Chronic Care Management (CCM) and Principal Care Management (PCM)
First came the CCM… Centers for Medicare & Medicaid Services introduced CCM in 2015. One may argue that the main idea behind CCM was to give health care professionals treating patients with chronic conditions a way to care for their patients more effectively. I say, CMS realized that a lot of work is being done in between office visits (calls, education, coordination, pre-authorizations and more) however providers were not getting paid for all that time, hence the burned out. So first came the CCM….
Multiple positive changes and additions happened in 2019 and 2022 which made CCM a lot more popular.
Then came the Principal Care Management (PCM) in 2020. Why new codes and new program when CCM is not as widely used as CMS would like?
CCM is the program for people with 2 or more chronic conditions, however 6 in 10 Americans have at least 1 chronic condition. PCM mimics CCM, however there are some notably difference you should know about.
| Chronic Care Management intended for | Principal Care Management intended for |
| People with 2+ chronic conditions | People with only 1 chronic condition |
| Mostly for Primary Care Providers | Mostly for Specialists |
| Requires Comprehensive Care Plan | Disease specific Care Plan |
| Minimum billing is 20 minutes (CPT 99490) | Minimum billing is 30 minutes (99424/5) |