APCM · Advanced Primary Care Management
Care-management revenue for your whole panel, no stopwatch required
APCM is Medicare's newest care-management program: one flat monthly payment per patient, tiered by complexity, with no time tracking. CareTrack runs it the same way we run CCM, staffed by our care team and documented in your EHR.
Medicare introduced Advanced Primary Care Management in 2025 to fix the two things practices dislike most about CCM: minute-counting and eligibility limits. APCM pays a flat monthly rate per patient across three complexity tiers, including a tier for patients with one or no chronic conditions, so nearly your entire Medicare panel is potentially eligible. For Qualified Medicare Beneficiaries, the top tier pays roughly double a standard CCM month, and those patients owe no cost-sharing.
The catch: billing APCM attests that your practice delivers a defined set of care-management capabilities, from 24/7 access and electronic care plans to transition-of-care follow-up, risk stratification, and population-level care-gap analysis. CareTrack supplies exactly that infrastructure. Our care team runs the outreach, care planning, and documentation under your protocols, in your EHR, and we assign each patient to APCM or CCM based on which program serves them, and your practice, best.
How it works
From panel to program
- 01
Stratify
We analyze your Medicare panel, risk-stratify it across the three APCM tiers, and flag where APCM out-earns CCM and where it doesn't.
- 02
Enroll
Our team obtains APCM-specific consent and coordinates initiating visits where required. An AWV can serve as the initiating visit, so the programs feed each other.
- 03
Care
Care coordinators deliver the required capabilities month over month: outreach, care plans, medication oversight, discharge follow-up, and 24/7 access.
- 04
Document & bill
Services are documented in your EHR and the monthly G-code is prepared per patient tier. No minute logs, no time-threshold audits.
Reimbursement
APCM CPT codes
The billing framework your practice uses. CareTrack tracks the time and documentation behind every code.
| Code | Description | Billing | 2026 nat’l avg* |
|---|---|---|---|
| G0556 | APCM Level 1: patients with 1 or fewer chronic conditions | Once per calendar month | $16 |
| G0557 | APCM Level 2: patients with 2 or more chronic conditions | Once per calendar month | $54 |
| G0558 | APCM Level 3: 2 or more chronic conditions plus Qualified Medicare Beneficiary status | Once per calendar month | $117 |
| G0568–G0570 | Behavioral health integration add-ons billable only with an APCM base code | New for 2026, once per month | — |
Model these rates against your panel with the ROI calculator →
Why practices run it
- Opens care-management revenue to patients CCM can't cover
- Ends the minute-counting and time-audit burden
- Top tier pays roughly double a standard CCM month for QMB patients
- Stacks with RPM and AWV for compounding per-patient revenue
Common questions
APCM FAQs
What is Advanced Primary Care Management (APCM)?
APCM is Medicare's monthly care-management bundle, introduced in 2025. Instead of tracking staff minutes like CCM, the practice bills one G-code per patient per month based on patient complexity: G0556 for patients with one or fewer chronic conditions, G0557 for two or more, and G0558 for patients with two or more conditions who are Qualified Medicare Beneficiaries. There are no time thresholds; billing attests that your practice delivers the required care-management capabilities, which CareTrack staffs and documents for you.
How is APCM different from CCM, and which should we offer?
CCM pays per 20-minute block of documented staff time and requires two or more chronic conditions. APCM pays a flat monthly rate with no time tracking, and Level 1 covers patients with one or no chronic conditions, so nearly your whole Medicare panel is potentially eligible. High-touch patients with heavy monthly engagement often earn more under CCM with add-on codes; lower-touch patients and QMB patients usually do better under APCM. Most practices run both, and CareTrack assigns each patient to the program that fits, since the same patient can't be in both in the same month.
Can APCM be billed in the same month as RPM or other programs?
Yes for RPM: remote patient monitoring codes bill alongside APCM in the same month, and Annual Wellness Visits and E/M visits remain separately billable too. APCM cannot be billed by the same practitioner in the same month as CCM, PCM, or TCM, and it bundles virtual check-ins and e-visits. New for 2026, behavioral health add-on codes (G0568, G0569, G0570) can be billed on top of an APCM base code.
What do patients have to agree to before we bill APCM?
A one-time consent, verbal or written, documented in the record. It must cover that cost-sharing may apply, that only one practitioner can furnish and bill APCM in a month, and that the patient can stop at any time. Existing CCM consent does not carry over, so transitioning patients need fresh APCM consent. New patients, or patients not seen in the last three years, also need an initiating visit, and an Annual Wellness Visit can serve that purpose. CareTrack's enrollment workflow handles all of it in your EHR.
What does CareTrack cost?
Pricing depends on your region's reimbursement rates and your patient mix, so we quote it per practice, typically structured so the program is profitable from the first month. Contact us and we'll model it on your panel's actual numbers.
More questions? See the full FAQ or contact us.
See APCM running on your EHR
A 20-minute walkthrough with your patient panel's numbers, not a canned deck.