decisionhealth Newsletters, Part B News - 2021 Issue 11 (November)
Navigate billing differences for coming principal care management codes
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Article Overview
This premium coding article is aimed at practices, coders, and billing professionals who need to understand how principal care management is being positioned for 2022 and how it differs from chronic care management. It covers the shift from temporary HCPCS G-codes to permanent CPT codes, the broad billing context for principal care management, and the general distinctions CMS has associated with the service. The article is useful for readers evaluating whether to add principal care management to their service mix and for those following Medicare/CPT alignment issues.
Why This Topic Matters
Understanding the billing framework for principal care management helps practices evaluate service setup, reimbursement strategy, and documentation needs as coding shifts from temporary HCPCS codes to permanent CPT codes.
What You Will Learn
- How principal care management is being transitioned from temporary HCPCS codes to permanent CPT codes
- How principal care management differs broadly from chronic care management
- Why the service is often discussed in the context of specialists and chronic condition management
- How CMS and CPT approaches to principal care management may affect billing
- What kinds of practice and reimbursement questions are raised by the change
Who Should Read This
- Medical coders
- Billing staff
- Practice administrators
- Compliance professionals
- Physicians and specialists
Codes Discussed
Code Ranges Discussed
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