tci E/M Coding Alert - 2022 Issue Q4

Reader Questions: Refresh Your Understanding of PCM Services

Question: Who can provide principal care management (PCM) services, and what activities will count in calculating time for them? Kentucky Subscriber Answer: CPT® provides two codes for PCM services performed personally by a physician or other qualified healthcare professional (QHP) and two codes for PCM services performed by clinical staff directed by a physician or other QHP. Physicians and other QHPs would report services they personally perform using 99424 (Principal care management services … first 30 minutes provided personally by a physician or other qualified health care professional, per calendar month) and +99425 (… additional 30 minutes …)...

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