With effect from 2022, Medicare stopped using two Healthcare Common Procedure Coding System G codes and started accepting four new CPT codes for principal care management (PCM) – CPT Code: G2064 and CPT Code: G2065. According to experts, the new codes give doctors the chance to increase outcomes while also increasing their earnings because they are paid at a greater rate than the G codes.

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How Can Physicians provide PCM Effectively?
With effect from 2022, Medicare stopped using two Healthcare Common Procedure
Coding System G codes and started accepting four new CPT codes for principal care
management (PCM) – CPT Code: G2064 and CPT Code: G2065. According to experts,
the new codes give doctors the chance to increase outcomes while also increasing their
earnings because they are paid at a greater rate than the G codes.
In that both services are provided to patients who need continuous clinical monitoring
and care coordination, PCM and chronic care management (CCM) are comparable. To be
eligible for PCM, patients must only have one complicated chronic condition, as opposed
to three or more for CCM, which is the opposite of PCM.

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3. How Will PCM Affect Healthcare Industry?
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Practitioners may now be compensated for giving their patients care management
solutions that are more focused within their own specific area of specialty thanks to the
new PCM codes. A patient’s primary care doctor may nevertheless offer more
comprehensive care management services as necessary. The new PCM codes, like the CCM
codes, may be used in conjunction with Remote Patient Monitoring codes (CPT Codes
99453, 99454, 99457, and 99091), and they may be used incidentally by a billing
practitioner while being overseen by the clinical personnel performing the services.

4. Learn About the Principal Care Management
Billing Criteria
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Patients must have one complex chronic disease that satisfies all six of the following
requirements in order to be eligible for principal care management (PCM) billing.
1. Should persist for at least three months.
2. Significantly increases the patient’s risk of hospitalisation, acute decompensation or
aggravation, functional decline, or even death.
3. Needs a care plan that is particular to the disease to be developed, monitored, or
revised.
4. Requires frequent modifications to drug schedules, and/or the condition’s care is
extremely difficult because of other conditions.
5. Demands constant contact and care coordination amongst pertinent healthcare
providers.
6. Requires PCM services for at least 30 minutes each calendar month.

5. Benefits of PCM
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1. Stabilization of Chronic Condition: One of the main objectives of PCM is to stabilise
a patient’s chronic condition as soon as feasible so that the patient’s primary care
physician can take over overall responsibility for their treatment. The patient would pay
far less for healthcare as a result.
2. Preventing Secondary Chronic Condition – The benefit of treating a chronic ailment
as soon as it manifests is that it significantly lowers the likelihood of a new, secondary
chronic condition developing. The care and attention that patients receive from their
healthcare professional is one overarching benefit of all of CMS’s initiatives.
3. Opportunities for Reimbursement – CMS enables providers to get PCM
reimbursements, providing your practise with an extra source of income.

6. How Can Physicians Provide PCM Effectively?
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Patient Selection – PCM is not necessary for all individuals with complex chronic
conditions. Be sure to note that the patient’s condition is so severe that hospitalisation is
either imminent or that the patient has already received multiple hospitalisations as a
result of the disease.
Patient Consent – Document the patient’s consent, and make sure to note that you’ve
informed them that their coinsurance is in effect.
Bill Correctly – Report CPT codes 99424 and 99425 if a physician or non-
physician performs the PCM, and record CPT codes 99426 and 99427 if a clinical staff
member or other certified professional supervises the service directly.
Outsource PCM Services – Identify the PCM service types you are presently offering,
but not charging. Do you have the ability to charge for those services in order to maybe
defray the expense of recruiting a new employee who may also be qualified to offer CCM
and TCM services? Outsourcing your services to a third party is also a beneficial option.
You can opt for an offshore medical billing agency to assist you with your PCM services
that can assist generate more revenue with minimal errors.

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Maximize Collections and Improve Patient
Care with Info Hub Services
CMS enables providers to increase revenue streams and enhance patient outcomes through
PCM. You may manage your patients more effectively by using our PCM solution, which has
many of the same features and resources as our CCM solution. In order to increase your
revenue and guarantee patient happiness, Info Hub, an offshore medical billing company,
offers its expertise with patient care enrolment and consent forms, plan assessments, and
monthly PCM time tracking.

8. About Us
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Though there are several common benefits offered by offshore medical
billing companies, but choosing the right medical billing partner plays a
vital role. Info Hub is one of the leading offshore medical billing companies
in Coimbatore, India, with sophisticated infrastructure and skilled
manpower that is highly experienced in multiple aspects of medical billing
and coding, to support healthcare practices grow heights and develop
consistency in generating revenue.
If you are looking to outsource your medical billing and coding services to a
reliable outsourcing partner, Info Hub is your ideal choice. With more than a
decade experience in providing excellent medical billing and coding
services, Info Hub has earned high client value by building trust with its top-
notch services. For a quick appointment, make a call to +1-888-694-8634 /
+91-0422-4212455.

9. Contact Us
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Info Hub,
Sf No 558/2, Udayampalyam Rd, Nava
India,
Coimbatore,
Tamil Nadu 641028
Call Us: +91 829-745-6441
Email Us At: inquiry@infohubservices.com