2026 billing guide · APCM
APCM Billing Codes for 2026: G0556, G0557, G0558, and the New Behavioral Health Add-Ons
Advanced Primary Care Management (APCM) is Medicare's newest care-management program, introduced in 2025. It replaces the per-minute bookkeeping of CCM with a flat monthly payment tiered by patient complexity, which removes the biggest operational objection to care management: time tracking.
For 2026, CMS expanded APCM with three behavioral health add-on codes, G0568, G0569, and G0570, that pay for psychiatric collaborative care and behavioral health integration in the same month as the APCM base code, also without minute counting.
This guide explains the three APCM levels, the new add-ons, the service elements a practice must be able to deliver, and how to decide between APCM and CCM for each patient.
The 2026 APCM codes at a glance
| Code | Description | Billing | 2026 nat’l avg* |
|---|---|---|---|
| G0556 | APCM Level 1: patients with 1 or fewer chronic conditions | Once per calendar month; one practitioner per patient | $16.30 |
| G0557 | APCM Level 2: patients with 2+ chronic conditions | Once per calendar month; one practitioner per patient | $53.50 |
| G0558 | APCM Level 3: 2+ chronic conditions and Qualified Medicare Beneficiary status | Once per calendar month; one practitioner per patient | $116 |
| G0568 | Psychiatric CoCM add-on to APCM, initial month | Calendar month; requires APCM base code same month · New for 2026 | $161.66 |
| G0569 | Psychiatric CoCM add-on to APCM, subsequent months | Calendar month; requires APCM base code same month · New for 2026 | $145.96 |
| G0570 | General behavioral health integration add-on to APCM | Calendar month; requires APCM base code same month · New for 2026 | $57.78 |
Free download
The 2026 Medicare care management rate sheet
Every CCM, APCM, PCM, RPM, and AWV code with its 2026 national rate, plus quick math for common patient months. Two pages, made for the billing office. Updated September 2026.
The three levels: G0556, G0557, G0558
APCM is billed once per calendar month at one of three levels set by patient complexity. G0556 covers patients with one or fewer chronic conditions, G0557 covers patients with two or more, and G0558 covers patients with two or more chronic conditions who are also Qualified Medicare Beneficiaries.
Unlike CCM, no minimum minutes are required in a given month. The payment assumes the practice delivers the full set of APCM service elements across the patient relationship, not a stopwatch total in each 30 days.
New for 2026: the behavioral health add-ons
G0568 pays for the first month of psychiatric Collaborative Care Model (CoCM) services delivered alongside APCM, and G0569 pays for each subsequent CoCM month. Both assume the CoCM team structure: treating practitioner, behavioral health care manager, and psychiatric consultant.
G0570 pays for general behavioral health integration without a psychiatric consultant. All three are crosswalked from the existing CoCM and BHI codes but drop the time-threshold requirements, matching the APCM philosophy.
What a practice must deliver
APCM carries the same service-element expectations that CCM built up over a decade: patient consent, an initiating visit for new patients, 24/7 access to care, a comprehensive electronic care plan, management of transitions between care settings, and performance measurement. CMS folded these into one monthly bundle rather than pricing each piece.
That bundle is exactly what CareTrack operates for partner practices: our care team delivers the elements and documents them in your EHR, and your practice bills the monthly code.
APCM versus CCM: one per patient per month
A practitioner cannot bill APCM and CCM (or PCM) for the same patient in the same month; APCM replaces them for that patient. The decision is per patient, not per practice, so a panel can run both programs side by side.
The economics differ by engagement level. A high-touch CCM patient with recurring add-on time (99439) can out-pay APCM Level 2, while lighter-touch patients and Qualified Medicare Beneficiaries usually favor APCM. Model your own panel in the ROI calculator to see the crossover point.
What still stacks with APCM
Remote patient monitoring bills alongside APCM in the same month, because RPM pays for the device and monitoring work rather than care coordination. Annual wellness visits are separate as well. The behavioral health add-ons stack by design, but only with the same practitioner in the same month as the base code.
Model these 2026 rates against your own panel with the ROI calculator →
APCM billing questions, answered
Which pays more for a practice, APCM or CCM?
It depends on the patient. CCM with consistent add-on time can exceed APCM Level 2 for highly engaged patients, while APCM usually wins for lighter-touch patients and always removes time tracking. Most practices run a mixed panel and choose per patient.
Can we bill RPM in the same month as APCM?
Yes. RPM pays for device supply and monitoring management, which Medicare treats as distinct from APCM's care-coordination bundle. CCM and PCM are the programs APCM replaces for a given patient.
Does APCM require tracking minutes?
No. APCM has no monthly time threshold at any level, and the 2026 behavioral health add-ons follow the same principle. The practice must deliver the APCM service elements, which is a capability requirement rather than a stopwatch requirement.
What makes a patient eligible for Level 3 (G0558)?
Two or more chronic conditions plus Qualified Medicare Beneficiary status. QMB is a Medicaid program that covers the patient's Medicare cost sharing, so Level 3 also removes the copay barrier that slows enrollment in traditional CCM.
Do the behavioral health add-ons require a psychiatrist?
G0568 and G0569 require the Collaborative Care Model team, which includes a psychiatric consultant. G0570, the general behavioral health integration add-on, does not require a psychiatric consultant.
Primary sources
Program overview: Advanced Primary Care Management
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