Keep the patient connected
Follow up around the condition-specific care plan.
Principal Care Management · PCMFocused support for a complex condition.
MySeema keeps the outreach, appointments and follow-through moving around one high-risk condition. Your clinician directs the plan while our team carries the agreed coordination and documentation.
Patients get personal follow-through
A coordination team you don’t have to recruit
Revenue potential from eligible services
More support, without a new coordination department
We take the follow-through off your team’s list.
Carry the next step
Coordinate referrals, appointments and practical needs.
Keep the plan visible
Document activity and surface questions for the responsible clinician.
MySeema carries the coordination.Your clinicians retain clinical decisions, oversight and the required clinical services. Your organization bills eligible services.
See a patient’s path through the service
- A patient is managing one complex condition.
- MySeema follows the agreed tasks and coordinates the next appointment.
- The responsible clinician stays informed and directs treatment.
Illustrative workflow, not an actual patient record or an outcome claim.
Anwar KaziCEO, IntraCare
ACO partnership experience · IntraCare
“Partnering with MySeema allows us to expand critical programs like remote monitoring and care navigation in a way that supports both patient health and our broader population health strategy.”
From MySeema’s broader care-management partnership.
Read about the partnership →PCM codes, at a glance.
Staff time
Clinical staff
- 99426
- First 30 minutes / month
- 99427
- Each additional 30 minutes
Qualifying condition-specific work under the responsible practitioner’s direction.
Estimate this base service →Practitioner time
Clinician personally
- 99424
- First 30 minutes / month
- 99425
- Each additional 30 minutes
The billing practitioner personally provides the qualifying time.
Estimate this base service →One qualifying high-risk condition and a disease-specific care plan. Staff and practitioner-personal pathways are distinct; do not count the same work twice.
See the revenue opportunity.
Choose a service and patient count. Adjust the assumptions if needed.
Requirements for the selected estimate
Codes modeled: None selected
One-off services and add-on codes are excluded unless they appear in the selected scenario.
The details, when you need them.
Which patients fit PCM?
- One complex chronic condition is expected to last at least three months.
- The condition places the patient at significant risk of hospitalization, acute decline, or other serious harm.
- Management requires a condition-specific care plan and coordination that is distinct from broad multi-condition care.
What must be in place before launch?
- Defined principal condition, clinical risk, and responsible practitioner
- Condition-specific care plan and task list
- Patient consent and cost-sharing communication workflow
- Clinical escalation criteria and approved documentation location
- Review of concurrent services and duplicate-work controls
Available when a condition-specific workflow is defined
Billing details, patient costs and service boundaries
- Choose the appropriate 30+ minute base pathway: 99426 for clinical-staff time or 99424 for time personally provided by the billing practitioner. Additional-time codes have separate requirements; do not count the same time twice.
- Document condition-specific care plan, necessary medication/treatment adjustments and coordination.
- Do not duplicate time, activities, or disease-management work billed elsewhere.
- This estimate assumes one billing practitioner, one principal condition and a completed initiating visit where required.
Patient cost sharing and protections depend on coverage and the service. Explain them before consent. Do not use this illustration to charge a Qualified Medicare Beneficiary protected amounts. RHC/FQHC payment rules and Medicare Advantage contracts differ from the national PFS benchmark.
Sources and review notes
Reviewed October 6, 2026. Estimates use the October 2026 CMS rate release.
Put a care team around your patients.
We’ll show you the coordination MySeema can take on, how it fits your practice and what the financial model could look like.