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Part of Principal Care Management

CPT 99426: Principal Care Management, clinical staff time, first 30 minutes

First 30 minutes per calendar month of principal care management furnished by clinical staff under the direction of a physician or qualified health professional.

Time threshold & code combinations

First 30 minutes of clinical staff time per calendar month.

  • 99427 is the add-on for each additional 30 minutes and cannot be billed without 99426 first in the same month
  • Do not bill 99426 and 99424 for the same time period

Who can bill

  • Clinical staff, under the general supervision of a physician or qualified health professional who bills the service

Eligibility & billing requirements

  • Single complex chronic condition expected to last at least 3 months, with significant risk as described in the program overview
  • Documented consent
  • A condition-specific care plan established or revised during the service period
  • Clinical staff time directed by the billing physician/QHP
  • Coordination with other treating practitioners

When to use it

Care coordinator managing a single complex condition

A care coordinator spends 30 minutes contacting a specialist, updating the medication list, and documenting changes to the care plan for a patient with severe asthma, under the supervising physician's direction.

Billing: 99426

Documentation checklist

  • Time log attributing minutes to clinical staff
  • Evidence of physician/QHP direction and oversight
  • Condition-specific care plan entry or revision

Common billing mistakes

  • Billing staff time under 99424 instead of 99426
  • No documented supervising physician/QHP direction