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PCMBase2026 Compliant

CPT 99424

2026 Billing Guide

PCM Phys 30 min

Reimbursement

$87.51

Threshold

30m

2026 Status

Active

What is CPT Code 99424?

CPT 99424 is defined as: Principal care management services, for a single high-risk disease, first 30 minutes provided personally by a physician or other qualified health care professional, per calendar month. This service is designed for patients with one complex chronic condition that is expected to last at least 3 months and places the patient at high risk of hospitalization or acute exacerbation.

This code is primarily used for PCM services. It falls under the category of Care Management / PCM and is valid for the 2026 calendar year according to the CMS Physician Fee Schedule.

2026 RVU Components

Relative Value Units (Non-Facility)

Standard Formula Applied

Work RVU

1.45

Physician Effort

PE (Non-Fac)

1.06

Practice Expense

Malpractice

0.11

Risk Factor

Total RVU

2.62

Note: [(Work RVU * Work GPCI) + (PE RVU * PE GPCI) + (MP RVU * MP GPCI)] * Conversion Factor

2026 CMS Policy Intelligence

efficiency shield

Protected from the -2.5% productivity adjustment (Time-based care management service).

specialist revenue optimization

PCM generates higher reimbursement ($83.50) than staff-led CCM ($61.96 for 99490), rewarding high-intensity specialist physician time.

fqhc rhc transition

G0511 is sunsetted. FQHCs must now itemize and bill 99424 for physician-led PCM to capture appropriate complexity.

Administrative Framework

Place of Service

11 (Office)22 (Outpatient Hospital)

NCCI Exclusions

Do not bill with:994909949199437G0511

Key Modifiers

25Often applied to the initiating E/M visit if PCM setup happens same-day.
G2211Applicable to the office E/M visit that manages the complex condition for which PCM is initiated.

Operational Requirements

minimum time

30 minutes personally performed by Physician or QHP per calendar month.

condition count

Single high-risk chronic condition ONLY (unlike CCM's 2+ requirement).

frequency

Once per calendar month.

provider type

Must be performed by MD, DO, NP, PA (not clinical staff).

Compliance Checklist

Documentation of at least 30 minutes of PERSONAL physician/QHP time.
Evidence of complex care plan development and revision for a single condition.
Consent for PCM services documented once per year or per episode.

Audit Defense

condition justification

Clear documentation of why this condition is 'high-risk' and requires specialized PCM instead of generic CCM.

time tracking

Audit risk if time is shared with clinical staff; 99424 requires personal physician time.

2026 Update

Medicare audits target the use of 99424 when physician effort is not clearly documented. Ensure logs distinguish between staff time (99426) and MD time (99424).

Common Clinical Scenarios

Cardiologist managing severe heart failure (I50.9) with multiple medication titration and coordination.
Endocrinologist managing type 1 diabetes (E10.65) with severe brittle glycemic control and insulin pump adjustment.
Oncologist managing advanced lung cancer (C34.90) with toxic side-effect management and palliative coordination.

Target Specialties & Utilization

CardiologyOncologyNephrologyEndocrinologyRheumatology

Typical Clinical Indications (ICD-10)

I50.9 (Heart failure, unspecified)C34.90 (Lung cancer)N18.5 (CKD Stage 5)E11.65 (Diabetes with hyperglycemia)

Frequently Asked Questions

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CPT Code 99424 for PCM Phys 30 min - 2026 Reimbursement & Rules