A turnkey managed service for single-condition specialty care pathways — extending your specialist workflow without adding headcount to your practice.
CHF Stage III — Enrolled 3 months
PCM is designed for patients managed primarily by a specialist for a single high-complexity condition. AuriaMedical builds specialty-aligned pathways for each practice.
PCM goes deeper on a single condition than CCM — all managed by AuriaMedical so your specialist workflow extends without adding headcount.
A structured, specialist-aligned care pathway specific to each enrolled patient's primary condition — built in coordination with your clinical protocols.
Patient engagement is calibrated to the specialist's clinical goals — not a generic care management protocol. Escalation and documentation are aligned to how your practice works.
Structured monthly outreach focused on the primary condition — medication adherence, symptom progression, side effects, and red flags requiring escalation.
When a patient's condition deteriorates or red flags are reported, escalation goes directly to the managing specialist — not to a call center or general triage.
Pre-visit preparation and post-visit follow-up for all specialist appointments — reducing no-shows and ensuring care plan continuity between encounters.
Precise per-patient monthly time tracking, fully documented and audit-ready — supporting 99426 and 99427 billing without manual effort from your staff.
Longitudinal documentation of condition-specific markers and patient-reported outcomes — building a meaningful clinical record between specialist visits.
AuriaMedical is the extension of your specialty workflow — no new hires, no new training, no administrative burden. Your team gets monthly billing data and clean escalation notes.
Every enrolled patient moves through a defined, repeating care cycle — managed end-to-end by AuriaMedical's clinical operations team.
PCM reimburses per-patient, per-month based on clinical staff time. No cap on add-on units — complex specialty patients drive strong monthly yield.
PCM (99426/99427) is for patients with a single complex, high-acuity condition managed primarily by a specialist. CCM (99490/99439) is for patients with two or more chronic conditions. The programs cannot be billed together for the same patient in the same month. AuriaMedical will identify the right program for each patient in your panel.
AuriaMedical builds your specialty-aligned care pathway, manages every patient touchpoint, and delivers the billing data. You keep your focus on clinical care.