99425 Prin care management phys each additional
Also known as: principal care management add-on, CCM additional, chronic disease management add
Principal care management services, for a single high-risk disease, chronic condition, or two or more chronic conditions lasting at least 30 days; each additional 15 minutes of physician or other qualified health professional time in a calendar month.
In Plain Language
Additional care coordination time; Extra chronic disease management
Clinical Context
Used to report each additional 15-minute increment of principal care management services beyond the first 30 minutes in a calendar month.
RVU Breakdown
| Work RVU | 1.00 |
| Total RVU | 1.00 |
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 1.00, this code ranks in the 30th percentile among Evaluation & Management codes — 1.5x below the median (1.54). The highest wRVU in this category is 18.46.
Specialties
Frequently Asked Questions
What is CPT code 99425?
CPT 99425 (Prin care management phys each additional) 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; each additional 15 minutes of physician or other qualified health professional time in a calendar month.
Who uses CPT code 99425?
CPT 99425 is used by Primary Care, All Specialties. Used to report each additional 15-minute increment of principal care management services beyond the first 30 minutes in a calendar month.
When is CPT 99425 used?
Used to report each additional 15-minute increment of principal care management services beyond the first 30 minutes in a calendar month.
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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.