Primary Care Management

Care for patients with a single chronic condition.

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Beginning in 2020, the Centers for Medicare and Medicaid Services (CMS) created a new program called Primary Care Management, also known as Principal Care Management (PCM).

The service is intended to provide additional care to patients with a single chronic condition or allowing a provider to treat a patient with multiple chronic conditions by focusing care solely on one of those chronic conditions.

Previously, CMS only allowed practices to be reimbursed for treating patients with two or more chronic conditions under their Chronic Care Management (CCM) program.

PCM was created to fill in the gaps, as many practices do see patients with only one chronic condition, but could stand to benefit greatly from focused care.

ValueCare Suite's tools for improved workflow

Daily Management Tools

We help you track and bill for services including communication with the patient and other treating health professionals for care coordination (both electronically and by phone), medication management, and being accessible 24 hours a day to patients and any care providers (physicians or other clinical staff). 

Dashboard

Track Monthly Progress, Staff Time Usage, Patient Assignment & Estimated Revenue.

Daily Task List

Easy workflow for keeping staff on task

Vital Alerts

Alerts and Tasks are assigned to staff members for daily completion.

Escalations

Physician's only need to check in when issues have excalated.

Patient List

Easily track and manage multiple Value-Based-Care programs. Sort and filter patient list to complete cares each month

Device Integration

Easily request BlackBox monitoring equipment from the patient's page. Drop ship to patients with one click. You can also order in bulk to keep devices in stock for clinic use.

Total Care. Wherever they go.

Primary Care Management

These are the codes you can use to bill Medicare for reimbursement of health care services rendered for a primary care management patient.

The monthly income is based on the national average of reimbursement.

CPT 99426

PCM Monitoring
$ 62 Monthly
  • Initial 30 minutes, clinical staff
  • Follow up calls
  • Vital tracking & more
  • Plan adjustements

CPT 99427

Additional PCM
$ 47 Monthly
  • PCM, clinical staff, +30 min.
  • Follow up calls
  • Vital tracking & more
  • Plan adjustements

CPT G0511

Care mgt., RHC/FQHC*
$ 77 Monthly
  • Rural Health Clinic, clinical staff or Federally Qualified Health Center, +30 min.
  • Follow up calls
  • Vital tracking & more
  • Plan adjustements

CPT 99424

(previously G2064)
$ 81 Monthly
  • Initial 30 minutes, physician or NPP
  • Follow up calls
  • Vital tracking & more
  • Plan adjustements

CPT 99425

Additional PCM
$ 59 Monthly
  • Subsequent 30 minutes, physician or NPP
  • Follow up calls
  • Vital tracking & more
  • Plan adjustements

Predictable Reimbursements

Increase practice revenue with predictable reimbursements in ValueCare Suite. 

Automatically calculate multiple billing codes simultaneously without duplication of services.

Calculate

Our built in calculator can help you predict what codes you can track for reimbursement.

Track

Easily track and manage multiple Value-Based-Care programs. Sort and filter patient list to complete cares each monthAutomatically collect patient data and follow patient monitoring within ValueCare Suite.

Vital Alerts

Reports for reimbursement are automatically generated at the end of each billing cycle.

ValueCare Suite has partnered with BlackBox RPM

We’ve partnered with BlackBox RPM hardware to provide a seamless end-to-end care experience for physicians and patients.

BlackBox‘s monitoring hardware is proven to be accessible for patients with minimal steps including equipment set-up, with one step, seamless capture and electronic transmission of data.