PCM Software For Focused Single-Condition Care

ChronicCareIQ helps high-volume Medicare practices manage patients with one high-risk chronic condition between visits, maintain condition-specific visibility, and capture reimbursable PCM activity while reducing manual administrative work.

4.8

800+ unsolicited patient reviews

What is Principal Care Management?

Principal Care Management reimburses providers, often specialists, for managing a single high-risk chronic condition between visits through disease-specific care planning, patient communication, and ongoing clinical management.

Patients with one complex chronic condition expected to last at least three months and requiring ongoing management, frequent adjustment, or disease-specific care coordination.

Around $87/month when provider-delivered (99424) or around $67/month when clinical-staff-delivered (99426), plus payment for add-on time. See the full breakdown below.

One High-Risk
Condition Creates
Many Loose Ends

A single serious condition can create most of the patient’s risk between visits; requiring follow-up, medication / treatment adjustments, care-plan updates, coordination with other providers, and more.

Without a connected PCM workflow, those activities get scattered across calls, EHR notes, tasks, and follow-up processes.

How ChronicCareIQ Simplifies PCM

For specialty practices, PCM becomes difficult to scale when one serious condition creates a steady stream of follow-up, medication or treatment adjustments, care-plan updates, provider coordination, and documentation work between visits.

ChronicCareIQ helps practices manage high-risk single-condition care in house by keeping patient visibility, condition-specific follow-up, documentation, and reimbursement connected in one scalable workflow.

Identify & Enroll Eligible Patients

Enroll eligible patients with chronic conditions, and organize patient panels around the ongoing follow-up needs your care team already uses.

Monitor The Condition Creating The Most Risk Between Visits

ChronicCareIQ’s color-coded RiskIQ dashboard helps care teams prioritize condition-specific changes and identify PCM patients who may require follow-up.

Capture & Document PCM Activity

ChronicCareIQ captures qualifying care activity and organizes audit-defensible documentation as your team follows up.

Leverages the EHR, phone systems, and connected devices your practice already uses.

Why Care Management Programs Fail As They Grow

How Much Do PCM
CPT Codes Reimburse?

CPT Code

What it covers

Time / requirement

Est. monthly reimbursement*

99424

Provider-delivered PCM — base

30 min physician/QHP time/mo

~$87

99425

Add-on to 99424

Each additional 30 min provider time (max 2×/mo)

~$61

99426

Staff-delivered PCM — base

30 min clinical staff time/mo

~$67

99427

Add-on to 99426

Each additional 30 min staff time (max 2×/mo)

~$54

**Estimated 2026 national non-facility Medicare reimbursement. Actual reimbursement varies by geography, payer, site of service, patient eligibility, documentation, and billing circumstances. This content is educational and is not billing, coding, or legal advice.

See Your Reimbursement Potential

Enter your NPI and we'll estimate the recurring monthly revenue your practice could generate from PCM and other programs — based on your real patient population.

Capturing Reimbursement For Focused Condition Management

$146/hour in reimbursable chronic care revenue

Advanced Medical Care used ChronicCareIQ to support care-management workflows across 2,100 patients with primarily cardiac conditions, helping the practice document and capture reimbursable activity tied to complex condition management.

“You need to make sure your vendor-partner understands all the nuances of chronic care management. ChronicCareIQ is just leaps and bounds above the rest.”

Dina Lemkova-Seryy, MS, Nurse Practitioner

PCM Is Made For Single-Condition Specialists

PCM is designed for the one high-risk condition driving most of a patient’s risk between visits. See how it supports the conditions your specialty manages.

Cardiology

Identify meaningful cardiac changes sooner through connected-device readings, symptom tracking, and condition-specific monitoring protocols.

Pulmonology

Track respiratory health between visits through oxygen saturation trends, symptom reporting, inhaler adherence, and treatment response.

Primary Care

Monitor chronic conditions between visits through symptom reporting, blood pressure, glucose, weight, mood, and medication adherence trends.

Nephrology

Monitor kidney health through blood pressure trends, fluid and weight tracking, symptom reporting, and medication adherence.

Neurology

Track neurologic symptoms, mobility changes, medication adherence, and functional status through structured assessments and monitoring.

Gastroenterology

Support ongoing behavioral health care through mood screening, medication adherence monitoring, risk assessment, and condition-specific protocols.

Behavioral Health

Support ongoing behavioral health care through mood screening, medication adherence monitoring, risk assessment, and condition-specific protocols.

Multi-Specialty

Manage multiple chronic conditions from one platform with symptom tracking, medication adherence monitoring, and specialty-specific care protocols.

When Patients Engage, Care Programs Scale

4.8 stars. 800+ patient reviews. Every rating below is unsolicited.
No incentives. No campaigns.

4.8

4.8

ChronicCareIQ has helped tremendously in keeping in touch with our patients on a constant and recurrent basis. It has also helped us improve our quality scores, decrease our emergency room utilization, and also decrease hospitalizations.

Dr. Salma SaigerInternist, Salma Mazhar MD PA Primary Care Clinic

Doctors are not going to be able to live without ChronicCareIQ. The convenience and regular contact with patients is the big key going forward.

Dr. Gary P. JonesThoracic Surgeon, Louisiana Cardiovascular & Thoracic Institute

As a healthcare provider committed to delivering the highest quality of care, ChronicCareIQ has become an indispensable ally in our mission. The platform's impact on patient outcomes, from reducing hospital admissions to enhancing communication and achieving financial success, has exceeded our expectations.

Dr. Jim Carmical MDPrimary Care Physician, Woodside Medical

I’ve really been pleased with our patient retention rate with ChronicCareIQ. Patients are very thankful for it and want to continue using it.

Dr. Brian FlowersCardiologist, Birmingham Heart Clinic

At Chesapeake & Washington Heart Care, we've seen remarkable improvements with ChronicCareIQ. It has greatly enhanced the efficiency of our phone interactions and the promptness in updating patient care. This has been vital in providing timely and effective healthcare services to our patients.

Gina Baxter Chief Operating Officer, Chesapeake and Washington Heart Care

With ChronicCareIQ, we are better in touch with our patients, and patients feel better knowing that they have daily or regular contact with our office. We have also seen a significant decrease in office call volume.

Dr. James WestInternist, Perimeter North Internal Medicine

ChronicCareIQ has helped tremendously in keeping in touch with our patients on a constant and recurrent basis. It has also helped us improve our quality scores, decrease our emergency room utilization, and also decrease hospitalizations.

Dr. Salma Saiger Internist, Salma Mazhar MD PA Primary Care Clinic

FAQ

How is PCM different from CCM?

PCM supports management of one specific high-risk chronic condition. CCM supports non-face-to-face care management for patients with two or more chronic conditions expected to last at least 12 months. ChronicCareIQ can help your practice evaluate which program fits your patients’ condition profile, documentation, and reimbursement strategy.

Can the same patient receive PCM and CCM in the same month?

PCM and CCM have different patient criteria and billing restrictions. Practices should evaluate patient eligibility, payer rules, timing, and documentation before billing either program. ChronicCareIQ helps organize program activity so your team can evaluate the right care-management path for each patient.

Which specialties are a strong fit for PCM?

PCM is often relevant for specialty practices managing serious single conditions, such as cardiology, pulmonology, nephrology, oncology, neurology, or other disease-specific programs where patients need ongoing condition management between visits.

How does ChronicCareIQ support condition-specific care plans?

ChronicCareIQ helps teams organize condition-specific follow-up, care-plan updates, patient communication, documentation, and reimbursement activity in one connected workflow.

Can PCM be used alongside RPM, TCM, APCM, BHI/CoCM, or CCM?

Many practices run multiple care-management programs, but billing depends on patient eligibility, payer rules, timing, documentation, and avoiding duplicate counting of the same activity. ChronicCareIQ software helps organize workflows and documentation so practices can evaluate the right program mix.

Who manages PCM work, providers or clinical staff?

Both provider-delivered and clinical-staff-delivered PCM workflows can be supported, depending on the billing model, staffing structure, and documentation requirements.

Build a modern,  Scalable PCM Program