Principal
Care Management
powered by AI

Medsien’s PCM solution enables practices to rapidly implement specialized care without incremental administrative work.

Meaningful care provided by dedicated, certified staff
Compliance and audit trails built in directly to your EHR
Profitable programs with hands-on support from start to finish
Remote Therapeutic Monitoring
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Significantly improve 
patients’ quality of life

As with all care management services, Medsien’s PCM solution enables practices to reach more people and provide additional, individualized support for their chronic conditions.

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Integrate directly and seamlessly with your EHR

Medsien’s technology platform creates a deep, bidirectional sync with EHR systems to simplify implementation and ongoing care management.

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Get up and

running—fast

Forget the red tape. Medsien can implement your PCM program in a matter of days, maximizing patient eligibility, streamlining enrollment and automating your administrative workflow.

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Introduced in 2020, Principal Care Management (PCM) is much like Chronic Care Management (CCM)

...but was introduced to allow specialists to choose a chronic condition that is relevant to their field

A patient would be eligible for Principal Care Management if they have only one chronic condition that is expected to last between three months and a year or until the death of the patient. It would be a condition that had led to a recent hospitalization and/or places the patient at significant risk of death, acute exacerbation/decompensation or functional decline.

Designed for speciality practices

Medsien can help practices rapidly implement Principal Care Management programs for their patients without incremental administrative work.

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Improve Medicare Compliance

Medsien automatically records and stores detailed documentation, audit trails and recordings of all patient communications, so you never have to worry about activities done for patients at any given time.

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Built-in timer in your EHR

Medsien's all in one dashboard allows providers to easily review and interpret patient data and take actions if necessary.

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Reduce administrative burden

Having a team of Care Partners who regularly check-in with your patients, means a lot less work for your providers and staff on typical tasks like scheduling appointments, referrals, etc.

Connect seamlessly with our comprehensive EHR ecosystem

With ever-growing number of technology integrations,
you can get up and running with Medsien in a matter of days.

Connect

We have a very simple implementation process for our PCM solutions and can go live within a week

Our team will manage all the aspects (eligibility, announcements, enrollment, etc.) so this will not take any time from you or your staff.

Eligibility

Medsien intelligently identifies your patients' eligibility based on their chronic conditions and insurance coverage to maximize your practice coverage.

1
Enrollment

Medsien's Enrollment Specialists contact your patients on your behalf and walk them through the enrollment process effortlessly.

2
Engagement

Every one of your patients will be assigned to a dedicated Certified Medical Assistant to improve engagement and deliver personalized care to your patients.

3
Our patients like the program, and we are very satisfied to partner with Medsien to add more value to our patients and revenue to our practice.
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Schedule a demo

Contact us to see Medsien in action and learn how your organization can reimagine remote care management.

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Frequently asked questions

Everything you need to know about principal care management.

What is principal care management?
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Principal care management (PCM) is the remote treatment of patients with a single chronic condition that is expected to last at least three months and places them at significant risk of death of functional decline.

What are examples of principal care management?
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Examples of a comprehensive principal care management plan include an expected outcome and prognosis with measurable treatment goals, cognitive and functional assessment, symptoms and medication management, and planned interventions.

What are the benefits of principal care management?
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Principal care management benefits patients by increasing their quality of care outside their doctor’s office with improved outcomes for high-risk chronic conditions. PCM services also benefit practices by reducing costs and generating additional revenue streams for care coordination.

Who is eligible for principal care management?
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To be eligible for principal care management, patients must be diagnosed with a single, high-risk chronic condition lasting at least three months. This condition must be of sufficient severity to place that patient at risk of hospitalization or have been the cause of a recent hospitalization. Moreover, management of this condition is usually complex due to comorbidities and requires frequent care revisions and/or medication adjustments.

What are the requirements for principal care management?
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Once a patient’s verbal or written consent to principal care management has been documented and an initial face-to-face vist has been completed, a physician or qualified healthcare professional must provide at least 30 minutes of care coordination per calendar month.

What is the difference between PCM and CCM?
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Similar to CCM, principal care management includes communication with a dedicated care partner throughout the month, However, unlike its CCM counterpart, PCM only requires patients to have one complex chronic condition. PCM also requires at least 30 minutes of care coordination throughout a calendar month.

Does Medicare cover principal care management services?
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Yes, as long as a patient’s chronic condition is eligible for principal care management, Medicare does reimburse PCM services. The four CPT codes through a PCM program include the creation of a care plan (99424), additional care coordination by physicians (99425) and initial and ongoing time carried out by clinical staff (99426 and 99427). Refer to CMS.org for the latest CPT code updates.

What are the billing guidelines for PCM?
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As with most care management programs, billing practitioners for PCM services must be physicians or other qualified healthcare professionals. It is possible for a patient to receive PCM services from multiple specialists for multiple different conditions simultaneously, but PCM services should not be billed at the same time as other care management services by the same practitioner for the same beneficiary.

Can PCM and CCM be billed together?
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Under CCM, a comprehensive care plan must be developed to receive reimbursement, but for PCM, only a disease-specific care plan is required. However, PCM and remote patient monitoring (RPM) can be billed in the same month, so long as the time spent providing services under each is not counted twice.

What is the average reimbursement for principal care management?
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As of 2023, national averages for reimbursement of principal care management services range from approximately $61 to $139 for each patient, depending on the billing code. This can equate to hundreds of thousands of dollars in additional annual revenue for the typical practice. With Medsien’s accurate, automated billing and coding, we achieve an average monthly reimbursement rate of 98%. Reach out to our team of PCM experts today to get started.

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Blog and resources

The latest news, technologies, and resources from our team.

Overview of CPT codes for Medsien related products
Overview of CPT codes for Medsien related products
Medsien offers software and solutions for a suite of services – including CCM, PCM, RPM, RTM, TCM and AWVs. Accurate coding is essential for proper reimbursement.
2024 Checklist to power up your practice. It’s time to reimagine remote care management
2024 Checklist to power up your practice. It’s time to reimagine remote care management
New year, time for a new approach It’s time to plan for 2024. Are you ready to introduce seamless, scalable remote care management and monitoring into your practice?
CMS 2024 Updates and Changes for Remote Care Services
CMS 2024 Updates and Changes for Remote Care Services
CMS continues to advance the ability of RPM and RTM services to drive revenue and improve the patient care experience. The 2024 Final Rule addresses billing scenarios and requests for clarifications on the appropriate use of these remote monitoring codes, and clarifies CMS’ position on how it interprets certain requirements for these services.
How to audit proof your remote care management programs
How to audit proof your remote care management programs
No one wants to be audited, but if your practice is audited – you want to be ready. Readiness requires you to have good, accurate data – that’s easily available.
A little less lonely: How remote care management improves the lives of seniors
A little less lonely: How remote care management improves the lives of seniors
Loneliness is a serious epidemic and major public health problem impacting individuals and communities in the United States and around the globe.
Why the benefits of remote care management implementation outweigh the risks
Why the benefits of remote care management implementation outweigh the risks
Robust remote care management programs help practices provide the highest quality of care resulting in better outcomes and reduced costs.
Re-imagine remote care management: Your roadmap to best-in-class remote care
Re-imagine remote care management: Your roadmap to best-in-class remote care
Medsien’s remote patient monitoring (RPM) programs combine an intelligent software platform with scalable staffing augmentation to create seamless, scalable programs with effortless implementation.
World class Remote Care Management during a recession? Here’s how.
World class Remote Care Management during a recession? Here’s how.
Recessions can impact a facility or provider’s bottom-line, patient care and health outcomes.
The Medsien Care Partner
The Medsien Care Partner
Medical Assistants (MAs) are an essential part of successful care management. At Medsien the two things that make our remote care programs so successful are our unique proprietary software and our staffing model.
How Medsien makes remote care programs easy to implement
How Medsien makes remote care programs easy to implement
You are busy, and do not have the staff or time to implement a care management program. Your practice can’t invest the money for care management right now.
Principal Care Management (PCM) Overview & Benefits
Principal Care Management (PCM) Overview & Benefits
CMS reimburses for Principal Care Management (PCM) services provided to beneficiaries with a single chronic condition needing to stabilize that condition following exacerbation or hospitalization.
Why should we hire someone else to do this?
Why should we hire someone else to do this?
The challenges of successful in-house Chronic Care Management (CCM) and Remote Patient Monitoring (RPM) programs