Live Webinar: Principal Care Management (PCM) in Foot & Ankle-Foot & Ankle Focus: Principal Care Management (PCM) in Foot & Ankle

Video Transcription

Video Summary

The AOFAS Foot and Ankle Focus webinar explains Principal Care Management (PCM), a CMS program introduced in 2020 to reimburse ongoing, non–face-to-face management of a single serious chronic condition lasting >3 months that places patients at risk of hospitalization, functional decline, complications, or mortality. The talk emphasizes PCM’s relevance to foot and ankle care—especially limb-threatening disease such as diabetic foot ulcers, Charcot neuropathy, chronic osteomyelitis/infection, peripheral vascular disease with ulcers, nonunions, and complex reconstructions—because these patients require frequent monitoring and coordination between visits (e.g., wound photo review, lab/imaging review, brace/cast checks, and communication with vascular surgery, infectious disease, endocrinology, or PCPs).<br /><br />PCM is billed in 30-minute increments (different codes for physician vs clinical staff) and cannot be billed the same day as an E&M visit; only one clinician can bill for the same condition per month. Success depends on audit-defensible documentation: a condition-specific care plan, patient consent (cost-sharing may apply), monthly updates, and proof of work occurring between visits. The presenter cautions about payer variability and outsourcing costs, and notes preoperative “optimization” may be higher risk for denials/audits if used as a one-time event rather than true longitudinal care.

Asset Subtitle

Faculty: Thomas Bemenderfer, MD, MBA; David Macknet, MD

This webinar will provide a framework of understanding for Principal Care Management (PCM), a program designed to support structured management of patients with a single high-risk chronic condition. In foot and ankle surgery, PCM is particularly relevant for limb-threatening diabetic disease, Charcot arthropathy, chronic infection, and complex postoperative surveillance extending beyond the global period. This session reviews compliant documentation, billing codes, and operation workflows required to implement PCM in orthopaedic practice. Participants will learn how PCM can improve patient outcomes while providing sustainable reimbursement for longitudinal specialty care.

At the conclusion of this webinar, you will be able to:

Define Principal Care Management (PCM) and understand CMS requirements, billing codes, and documentation necessary for compliant implementation
Identify relevant foot and ankle conditions, including limb-threatening diabetic foot disease, Charcot arthropathy, chronic osteomyelitis, and nonunion surveillance
Develop a workflow for implementing PCM in orthopaedic practice, including patient identification, consent, care-plan creation, and staff-driven monitoring
Differentiate PCM from global surgical care and G2211, ensuring proper compliance while capturing legitimate longitudinal care reimbursement
Recognize how PCM programs can improve patient outcomes, reduce complications and hospitalizations, and create sustainable practice revenue through structure chronic disease management

Keywords

Principal Care Management (PCM)

CMS reimbursement program

non-face-to-face chronic care management

AOFAS Foot and Ankle Focus webinar

diabetic foot ulcers

Charcot neuropathy

chronic osteomyelitis and infection

peripheral vascular disease with ulcers

PCM billing codes and documentation requirements