Principal Care Management (PCM)

Principal Care Management (PCM) G2064 and G2065 are billed for non-face-to-face comprehensive care management services furnished to Medicare beneficiaries for one serious high-risk chronic condition.

This chronic condition needs to have lasted at least 3 months, which is the focus of the care plan, the condition is of sufficient severity to place the patient at risk of hospitalization or have been cause of a recent hospitalization, the condition requires development or revision of disease-specific care, the condition requires frequent adjustments in the medication regimen and/or the management of the condition is unusually complex due to comorbidities.

  • G2064 (1.45 RVUs for 30 mins of a provider’s time per month)
  • G2065 (0.61 RVUs for 30 mins of clinical staff time per month)

PCM can be billed by a specialist(s) even if another provider is billing for chronic care management (CCM) services. Also, a PCP can bill for PCM services if not billing for CCM.