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CPT Codes For Principal Care Management Services

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This article was published more than 1 year ago. While we strive to keep our content up to date, medical coding guidelines and regulations may have changed since then.

Below is a list summarizing the CPT codes for principal care management services.

CPT Code 99424

CPT 99424 describes a principal care management service for a single high-risk disease that requires frequent adjustments in the medication regimen, ongoing communication and care coordination between relevant practitioners, and the first 30 minutes of care provided personally by a physician or other qualified healthcare professional per calendar month.

CPT Code 99425

CPT 99425 describes an add-on procedure for principal care management services for a single high-risk disease that requires the development, monitoring, or revision of a disease-specific care plan, frequent adjustments in the medication regimen, and/or unusually complex management due to comorbidities, as well as ongoing communication and care coordination between relevant practitioners furnishing care, with each additional 30 minutes provided personally by a physician or other qualified health care professional, per calendar month and should be list separately in addition to code for primary procedure.

CPT Code 99425

CPT 99425 describes principal care management services for a single high-risk disease that requires frequent adjustments in the medication regimen, ongoing communication and care coordination between relevant practitioners, and the development, monitoring, or revision of a disease-specific care plan due to the complexity of the condition and comorbidities.

CPT Code 99427

CPT 99427 describes an add-on procedure for a principal care management service for a single high-risk disease that requires frequent adjustments in the medication regimen and/or the unusually complex management of the condition due to comorbidities, ongoing communication and care coordination between relevant practitioners furnishing care. Each additional 30 minutes of clinical staff time is directed by a physician or other qualified health care professional per calendar month and should be listed separately in addition to the code for primary procedure.

This content may be outdated

This article was published more than 1 year ago. While we strive to keep our content up to date, medical coding guidelines and regulations may have changed since then.

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