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PCMBase2026 Compliant

CPT 99426

2026 Billing Guide

PCM Staff 30 min

Reimbursement

$63.46

Threshold

30m

2026 Status

Active

What is CPT Code 99426?

CPT 99426 is defined as: Principal care management services, for a single high-risk disease, first 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month. This service is for patients with one complex chronic condition requiring disease-specific coordination and management.

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

0.05

Physician Effort

PE (Non-Fac)

1.81

Practice Expense

Malpractice

0.04

Risk Factor

Total RVU

1.9

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).

specialization premium

Staff-led PCM ($63.13) pays slightly more than CCM ($61.96 for 99490), reflecting the focused intensity of single-disease expertise.

fqhc rhc transition

FQHCs must now transition from G0512/G0511 to itemized 99426 billing for staff-led PCM and capturing the 30-minute threshold.

Administrative Framework

Place of Service

11 (Office)22 (Outpatient Hospital)

NCCI Exclusions

Do not bill with:994909949199424G0511

Key Modifiers

G2211Applicable to the directing physician's office visit where the PCM plan is established.

Operational Requirements

minimum time

30 minutes of cumulative clinical staff time per calendar month.

condition count

Single high-risk chronic condition ONLY.

frequency

Once per calendar month.

supervision

General supervision by Physician/QHP ('incident-to').

Compliance Checklist

Time-log of staff activities totaling 30+ minutes.
Identification of the single specific condition being managed.
Care plan that is condition-specific (not just a generic chronic disease plan).

Audit Defense

disease focus

Audit records must show interventions specifically for the primary high-risk disease. Generalized care should be billed as CCM instead.

no double billing

Cannot bill CCM 99490 and PCM 99426 for the same patient in the same month.

2026 Update

A common audit failure is billing PCM for stable, low-risk single conditions. Documentation must show 'high-risk' status (expectancy of hospitalization).

Common Clinical Scenarios

Renal nurse managing stage 4 CKD (N18.4) patient, monitoring lab results and dietary adherence.
Cardiac nurse coordinating advanced heart failure (I11.0) protocols and monitoring daily weights via phone check-ins.
Clinical staff managing a complex uncontrolled diabetic patient's titration plan under physician direction.

Target Specialties & Utilization

NephrologyCardiologyNeurologyGastroenterology

Typical Clinical Indications (ICD-10)

N18.4 (Stage 4 CKD)I11.0 (Heart failure with HTN)J44.1 (COPD exacerbation)G30.9 (Alzheimer's disease)

Frequently Asked Questions

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