CPT® Code 99425

Add-On Code

Principal care management services, for a single high-risk disease, with the following required elements:

• one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or death,
• the condition requires development, monitoring, or revision of disease-specific care plan,
• the condition requires frequent adjustments in the medication regimen and/or the management of the condition is unusually complex due to comorbidities,
• ongoing communication and care coordination between relevant practitioners furnishing care;

each additional 30 minutes provided personally by a physician or other qualified health care professional, per calendar month (List separately in addition to code for primary procedure)