99424 Prin care management phys first 30
Also known as: principal care management, chronic care management, disease management
Principal care management services, for a single high-risk disease, chronic condition, or two or more chronic conditions lasting at least 30 days; care plan oversight and coordination of care by a physician or other qualified health professional; first 30 minutes of physician or other qualified health professional time in a calendar month.
In Plain Language
Care coordination for chronic disease; Chronic condition management
Clinical Context
Used for comprehensive care management services for patients with high-risk, complex chronic conditions requiring intensive coordination and oversight by physician or qualified health professional.
RVU Breakdown
| Work RVU | 1.45 |
| Total RVU | 1.45 |
Est. Medicare Payment
National estimate based on 2026 CMS PFS Conversion Factor ($33.40). Actual payment varies by locality (GPCI adjustment).
Billing & Documentation
E&M codes require documentation of medical decision-making (MDM) complexity or total time spent on the encounter. For 2026, time-based coding includes all physician time on the date of the encounter.
How This Code Compares
With a work RVU of 1.45, this code ranks in the 41st percentile among Evaluation & Management codes — 1.1x below the median (1.54). The highest wRVU in this category is 18.46.
Specialties
Frequently Asked Questions
What is CPT code 99424?
CPT 99424 (Prin care management phys first 30) is a Evaluation & Management code. Principal care management services, for a single high-risk disease, chronic condition, or two or more chronic conditions lasting at least 30 days; care plan oversight and coordination of care by a physician or other qualified health professional; first 30 minutes of physician or other qualified health professional time in a calendar month.
Who uses CPT code 99424?
CPT 99424 is used by Primary Care, All Specialties. Used for comprehensive care management services for patients with high-risk, complex chronic conditions requiring intensive coordination and oversight by physician or qualified health professional.
When is CPT 99424 used?
Used for comprehensive care management services for patients with high-risk, complex chronic conditions requiring intensive coordination and oversight by physician or qualified health professional.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.