Non-dialysis CKD with blood-pressure or fluid-management needs
Talk with us FOR YOUR PRACTICE · NEPHROLOGY
Keep kidney care connected between visits.
For appropriate non-dialysis CKD patients, PrimeVital can coordinate home readings, follow-up, documentation and billing handoffs around your nephrologist’s plan.
PATIENT FIT & PROGRAM CHOICES
Start with the patient and the work that needs doing.
Clinical need, an accountable billing practitioner, payer coverage and actual service requirements determine the pathway. A diagnosis alone is not enough.
One complex kidney condition needing repeated medication, test and referral follow-through
Patients returning from a qualifying hospital stay
01 · CORE MONITORING OPTION
RPM · Home physiologic readings
Use a qualifying connected device when blood pressure or weight trends will inform care. Device transmission and treatment-management time have separate requirements.
Read RPM requirements 02 · CONDITION-FOCUSED OPTIONPCM · One complex condition
For one serious, high-risk kidney condition needing a disease-specific plan and qualifying monthly management time.
Read PCM requirementsOther pathways to assess separatelyTCM for a qualifying discharge CCM if this practice owns whole-person care management
Behavioral health can be part of the care plan.
Explore BHI and CoCM General BHI may fit when the treating practitioner and care team provide the required ongoing behavioral-health work. Psychiatric CoCM needs a separate consultant, care manager and registry; it is not assumed in our service example.
Dialysis and ESRD monthly-service arrangements may bundle or conflict with care-management claims. Review those patients separately; this illustration assumes non-dialysis care.
SANTA CLARA COUNTY, CALIFORNIA · ORIGINAL MEDICARE · OCT–DEC 2026
A 100-patient panel: two possible service pathways.
This is one hypothetical period using non-facility Medicare allowed amounts. It is a service-level illustration, not a forecast of eligibility, collections or profit.
$74.79 device supply (99454) + $66.49 first 20 minutes of management (99457) per qualifying patient, each only when its requirements are met.
$84.24 clinical-staff management (99426) per qualifying patient-month, with separate condition, time and documentation requirements.
Before cost share, sequestration, denials, payer contracts, PrimeVital fees, device costs and practice oversight. This is neither expected collections nor practice profit.
The 70 RPM and 40 PCM counts are hypothetical service counts within a 100-person panel; some patients could qualify for both only if the services and time are distinct. CCM or a qualifying transition may be another route, but is not included in this total.
Before we quote your practice: we check payer mix, who already bills each service, eligibility, documentation, place of service, cost share and actual operating fees. Behavioral health integration is a separate clinical pathway and is not assumed in these figures.
Sources: CMS RVU26D and the 2026 carrier file for amounts; CMS remote monitoring, care management FAQ, TCM and BHI for requirements.
HOW WE WORK WITH YOUR PRACTICE
We can run the operational work without adding a new in-house coordinator.
Scope, access and escalation responsibilities are set in the agreement. Your practice retains clinical authority and billing accountability.
PrimeVital can operate
- Patient list preparation, onboarding and permitted outreach
- Device and transmission support where RPM fits
- Care-team follow-up, task routing and documented handoffs
- Exception review, evidence tracking and RCM handoff
Your clinical team directs
Your nephrologist selects patients, sets thresholds and care plans, makes treatment decisions, reviews escalations and remains responsible for claims.
No new dedicated coordinator is assumed in the illustration; clinician oversight and responses remain necessary.
Patient at homePrimeVital care operationsTreating specialistDocumented service & claim review
DESIGN A PRACTICAL STARTING POINT
Tell us where the workflow is breaking. We’ll show you where to begin.
Send us a message
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