Principal Care Management
Better Chronic Disease Management Starts Here
Wellwink delivers an end-to-end solution for Principal Care Management (PCM), ensuring better health for your patients and seamless workflows for your team. Enroll. Plan. Bill. Done.
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~$6.61 B
Global Market Value
~65 M
Medicare Beneficiaries
13.62%
Market Projected Growth
~90%
Care Coordination for Value-Based Care Success
Effective PCM programs directly improve patient outcomes (e.g., fewer hospitalizations), helping providers meet quality metrics and maximize financial bonuses from Accountable Care Organizations (ACOs) and other programs.
- Real-time dashboards provide live tracking and management of all clinical and operational activities.
- Log non-face-to-face PCM time instantly, generating a complete audit trail for verifiable billing and claims accuracy.
- The system automatically assigns appropriate CPT codes and conditions to claims, directly based on the documented time spent with the patient.
Automate your clinical workflow for peak efficiency.
Create targeted care plans focused on the patient’s specific health goals.
Utilize digital tools to connect patients and care teams, driving better outcomes.
Meet or surpass all performance metrics to maximize your payment incentives.
We are geared to disrupt the industry and alter the ways healthcare is provided
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Patients That We Enroll
Eligibility Criteria for the PCM Patient
One complex chronic condition
Condition lasts for at least 3 months
Insured by Medicare
No overlapping programs
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The qualifying chronic condition must be complex and anticipated to last for a minimum of three months.
- The patient is at risk for hospitalization or has a recent history of hospitalization stemming from the condition.
- Treatment requires frequent medication adjustments, and/or the condition’s management is complex due to co-occurring illnesses (comorbidities).
- Development or revision of a disease-specific care plan is required.
How does PCM work?
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CPT Billing Codes and Reimbursement for PCM
CPT-99424
The first 30 mins are provided personally by a physician
$80.87
Medicare National Payment Amount (2025)
CPT-99425
For each additional 30 mins provided personally by a physician
$58.87
Medicare National Payment Amount (2025)
CPT-99426
The first 30 mins of clinical staff time directed by the physician
$61.78
Medicare National Payment Amount (2025)
CPT-99427
For each additional 30 mins of clinical staff time directed by the physician
$50.46
Medicare National Payment Amount (2025)
*Reimbursement rates are based on a national average and may vary depending on your location.
Check https://www.cms.gov/medicare/physician-fee-schedule/search/ for the latest information.
Profitable PCM Reimbursements from Medicare
$61.78
250
$15,445
Monthly reimbursement.
Frequently Asked Questions
What is Principal Care Management (PCM)?
What is the main difference between PCM and Chronic Care Management (CCM)?
How much time is required to bill for PCM services?
Can a patient receive PCM from multiple specialists?
What types of providers can bill for PCM?
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