PCM Software Solutions for Patients with One Complex Chronic Condition
Vervelo's PCM platform gives specialist and primary care teams a purpose-built workflow to deliver, document, and bill focused care management.
Measurable Outcomes for Focused Chronic Condition Care
PCM lets your practice generate meaningful recurring revenue while delivering intensive, condition-specific care management to your highest-complexity patients.
PCM Billing
79%
PCM Billing from Enrolled Complex Patients
Time Saved
45%
Reduction in Care Manager Documentation Time
Readmissions
34%
Fewer 30-Day Readmissions for PCM-Enrolled Patients
Revenue
$85–$120
Per Patient Per Month (CPT 99424–99427)
Features
A Purpose-Built Feature Pack for Your Principal Care Management Platform
From identifying eligible single-condition patients to generating compliant 99424–99427 claims, Vervelo's PCM module handles every step of the care management lifecycle.
Principal Care Management
Identify and Enroll Eligible PCM Patients
Vervelo automatically scans your patient panel and flags those with a single high-complexity chronic condition who meet CMS PCM eligibility criteria — cross-referencing ICD-10 codes, active prescriptions, and visit history.
Principal Care Management
Condition-Specific Electronic Care Plans
Build CMS-compliant care plans centered on the patient's principal condition with pre-built templates for 20+ diagnoses, reducing documentation time by up to 75%.
Principal Care Management
Automated 30-Minute Time Tracking
Every call, message, and care coordination activity is automatically timed and attributed to PCM. Alerts fire at 20 minutes to ensure every enrolled patient reaches the billing threshold.
Principal Care Management
Intelligent PCM Revenue & Billing Dashboard
One-click claim generation with automatic 99424–99427 code assignment and a pre-submission denial prevention checklist for every PCM patient.
Why Vervelo For Principal Care Management?
Automatically identify eligible single-condition patients, enroll them with one-click consent capture, document all condition-specific interactions, track time continuously against the 30-minute threshold, and generate compliant 99424–99427 claims — all from a single platform.
Vervelo offers two engagement models -
- PCM Software Platform Only
- PCM End-to-End Managed Service
HIPAA Compliant
Protects data during storage and transmission
Web-Based
Accessible from any secure web browser
EHR Compatible
Integrates with your existing EHR system
Scalable
Supports multi-provider and multi-location setups
Primary Aims of Principal Care Management
PCM is designed for practices managing patients whose care complexity is driven by a single dominant condition. Vervelo helps you deliver measurable clinical and operational value across your most complex patients.
Intensive Single-Condition Focus
PCM is explicitly designed for patients whose care burden is dominated by one complex chronic condition — such as heart failure, uncontrolled diabetes, advanced COPD, or CKD stage 4. Vervelo keeps all clinical activity anchored to that principal diagnosis, ensuring documentation clarity and billing compliance.
Reduce Condition-Driven Hospitalizations
By providing structured monthly touchpoints, medication reconciliation, and care plan reviews specifically targeting the principal condition, PCM reduces the unplanned acute events that drive the highest costs — 30-day readmissions, ED visits, and care escalations.
Unlock New Specialist Revenue Streams
PCM codes 99424–99427 are billable by the specialist managing the principal condition — making PCM a natural revenue opportunity for cardiology, pulmonology, nephrology, endocrinology, and other specialty practices that already manage high-complexity patients.
Coordinate Across the Full Care Team
Even though PCM focuses on one condition, Vervelo tracks referrals, specialist consultations, lab reviews, and care transitions — ensuring that all team members aligned to the principal condition are coordinated and documented.
Improve Operational Efficiency
Vervelo automates the most time-consuming parts of PCM administration — eligibility identification, care plan generation, time tracking, and billing — so your care managers can spend more time with patients and less time on documentation overhead.
Drive Patient Adherence and Self-Management
Vervelo's patient communication tools send automated reminders for medication adherence, lab follow-ups, and scheduled check-in calls — keeping patients engaged between visits and reducing the likelihood of condition exacerbation.
Over 120+ custom healthcare solutions Built and developed to deliver excellent patient care, drive clinical innovation and meet regulatory compliance standards
Our expertise in healthcare
Healthcare software development success case studies
4x
faster RPM launch and deployment across 3 clinics
CarePlus TeleHealth
Built a custom remote-patient-monitoring (RPM) platform for a U.S. home-care provider, allowing them to deploy monitoring to 3 clinics in under 8 weeks — four times faster than their previous in-house attempts.
View case study
60%
staff-time savings on admin tasks
GrandView Hospital
A major hospital system with fragmented legacy systems engaged Vervelo to build an integrated EHR + billing + patient portal + telehealth platform.
View case study
5x
growth in patient engagement
HealthBridge
Health-tech startup partnered with Vervelo to build a patient portal and mobile app with tele-consultation, RPM data sync, and automated follow-ups.
View case study
Compliance-First Software that Protects Your and Your Patients' Data
We build healthcare software with compliance and security built in from the start. Our team understands HIPAA, FDA guidance, ISO 27701, GDPR, SOC 2 and modern interoperability (HL7 FHIR). We design solutions that help protect patient data, make audits easier, and support trust across your organization.
Vervelo is a digital-health software partner blending deep clinical insight with world-class engineering to build tailored, secure, interoperable healthcare platforms. With a team of HIPAA- and FHIR-trained professionals and a track record of delivering 120+ custom healthcare solutions, we help healthcare providers, startups, and health-tech companies accelerate innovation, improve patient care, and simplify operations.
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Vervelo designs your PCM platform around your specialty and the specific conditions you manage most — so your workflow reflects how your team actually operates.
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Choose only the PCM modules you need. Nothing extra to slow things down.
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We don't charge subscription fees or take a cut of your patient billing like traditional EMRs.
What is the difference between PCM and CCM?
CCM covers patients with two or more chronic conditions and has a 20-minute monthly time requirement. PCM is designed for patients with a single high-complexity chronic condition requiring intensive ongoing management. PCM requires 30 minutes of clinical time per month and is billed under CPT codes 99424–99427. A patient can only be enrolled in PCM or CCM — not both — in the same month.
Which specialties most commonly bill PCM?
PCM is most commonly billed by cardiology (heart failure, AFib), pulmonology (COPD), nephrology (CKD), endocrinology (uncontrolled diabetes), and neurology. Primary care practices also bill PCM for patients where one condition dominates their care complexity.
What CPT codes are used for PCM and what do they reimburse?
PCM uses four CPT codes: 99424 (first 30 min/month, ~$85), 99425 (each additional 30 min, ~$48), 99426 (complex PCM, first 30 min/month, ~$107), and 99427 (complex PCM, each additional 30 min, ~$55). Vervelo's billing dashboard automatically assigns the correct code based on time logged and complexity documentation.
Can non-physician clinical staff perform PCM services?
Yes. CMS allows clinical staff (RNs, LPNs, MAs) to perform and document PCM services under the general supervision of a billing physician. Vervelo supports multi-staff time aggregation, so time logged by any care team member rolls up into the monthly PCM billing summary.
How long does it take to go live with Vervelo PCM?
Most practices are live and billing their first PCM claims within 3–4 weeks of kickoff. Practices with an existing CCM program can onboard PCM in as little as 2 weeks by extending their existing workflows.