Principal Care Management for one serious condition.
Clinical oversight on every account
HIPAA Business Associate
Documentation inside your EHR
CPT 99424 / 99425 / 99426 / 99427
What Zenith handles every month
Focused, single-condition management with clinical oversight.
Eligibility screening
We find patients with one qualifying high-risk condition and confirm coverage.
Condition-focused care plan
A plan built around the single condition, with goals your provider signs.
Monthly outreach
Calls and messages that check symptoms, readings and understanding.
Specialist coordination
We keep the specialist, the pharmacy and your office on the same page.
Medication support
Reconciliation and adherence follow-up for the drugs tied to that condition.
Time logs and notes
Audit-ready documentation in your EHR every month.
How it works
Three steps from the first call to a program running inside your EHR.
Book a 15-minute call01
Find the right patients
We review your panel for patients with one serious condition who are not being managed under another monthly program.
02
Deliver monthly management
Clinical staff spend the required time each month on that condition and document it.
03
You bill, Zenith invoices
Your practice bills the PCM codes. Zenith invoices you for the clinical labor.
Who we serve
Eligibility is confirmed per patient and per payer at the time of service. The guidance below shows who this service is built for.
Eligible practices
Cardiology, Endocrinology, Pulmonology, Nephrology, Neurology, and other specialty practices managing one dominant condition; also usable by Primary Care and Internal Medicine for a single high-risk condition.
Patients who can be billed
Medicare Part B patients with one complex, high-risk chronic condition expected to last at least 3 months. It cannot be billed for the same patient, in the same month, alongside CCM by the same provider.
What’s billed
| CPT | What it covers | ~Rate |
|---|---|---|
| 99424 | First 30 min/month, physician or QHP time | ~$88 |
| 99425 | Each additional 30 minutes, physician/QHP | ~$61 |
| 99426 | First 30 min/month, clinical staff | ~$68 |
| 99427 | Each additional 30 minutes, clinical staff | ~$54 |
PCM and CCM can't be billed for the same patient in the same month by the same provider, but a specialist can bill PCM for one condition while the patient's PCP separately bills CCM for others.
~$68-$88 / mo
Per enrolled patient, depending on who performs the time. Figures are 2026 national averages and vary by locality.
Plug in your real numbers to see the figure for your panel, the calculator runs entirely in your browser.
Estimate your panel sizePrincipal Care Management (PCM) resources
Patients with two or more chronic conditions fit Chronic Care Management.
Principal Care Management (PCM): common questions
Related care management services
Fifteen minutes to see if it fits.
We’ll walk through how Principal Care Management (PCM) works for your practice, confirm the fit, and tell you honestly whether Zenith is the right partner.