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PCMAdd-on2026 Compliant

CPT 99425

2026 Billing Guide

PCM Phys Add-on 30 min

Reimbursement

$61.46

Threshold

30m

2026 Status

Active

What is CPT Code 99425?

CPT 99425 is defined as: Principal care management services, for a single high-risk disease, each additional 30 minutes provided personally by a physician or other qualified health care professional, per calendar month (List separately in addition to code for primary procedure).

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

Physician Effort

PE (Non-Fac)

0.77

Practice Expense

Malpractice

0.07

Risk Factor

Total RVU

1.84

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 (Care Management service).

revenue capture

Physician-led PCM add-ons ($60.12) are more valuable than staff-led add-ons ($48.43 for 99427), reflecting higher medical decision-making intensity.

fqhc rhc transition

FQHCs can now scale PCM reimbursement based on actual physician effort using 99425 units instead of the flat G0511.

Administrative Framework

Place of Service

11 (Office)22 (Outpatient Hospital)

NCCI Exclusions

Do not bill with:9943999489G0511

Key Modifiers

G2211Applicable to the office visit context; 99425 supports the high-intensity longitudinal complexity of a single specific condition.

Required Primary Codes

Must be billed alongside a primary service.

Operational Requirements

minimum time

Each additional 30 minutes (Threshold starts at 60 total personal Physician/QHP minutes).

primary code

99424 (Must be billed for the first 30 minutes).

frequency

Multiple units allowed in a calendar month if medical necessity is documented.

provider type

Personal physician/QHP time only.

Compliance Checklist

Aggregate personal physician time for the month (e.g., 60+, 90+, 120+ minutes).
Documentation showing the medical necessity for the extended time (e.g., acute instability).
Activities must be distinct from staff-performed tasks.

Audit Defense

time clash

Ensure MD/QHP time does not overlap with time billed for other management services (e.g., CCM or RPM).

decision log

Audit defensive notes should focus on the 'why' behind the extra physician time (e.g., 'coordinated with transplant team').

2026 Update

Medicare audits focus on high-volume 99425 billing. Maintain detailed, time-stamped clinical notes for every 30-minute block.

Common Clinical Scenarios

Cardiologist managing heart failure patient with severe titration issues requiring 65 minutes of personal clinical review and plan adjustment (Bill 99424 + 1 unit of 99425).
Oncologist coordinating complex clinical trial medication and managing severe adverse reactions totaling 95 minutes in one month (Bill 99424 + 2 units of 99425).

Target Specialties & Utilization

OncologyNephrologyAdvanced Heart FailureRare Disease Specialists

Typical Clinical Indications (ICD-10)

I50.31 (Acute on chronic systolic heart failure)C18.9 (Colon cancer, unspecified)N18.6 (End stage renal disease)

Frequently Asked Questions

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