Advanced Primary Care Management (APCM)
What is Advanced Primary Care Management?
Eligibility Requirements:
Patients with chronic or high-risk conditions needing ongoing management.
A physician or qualified healthcare professional must establish and oversee the care plan.
Documentation must demonstrate proactive care coordination and patient engagement
activities.
Initial comprehensive assessment and care planning.
APCM CPT/HCPCS Codes : G0556
Once per patient, per 12 months.
Comprehensive assessment and care planning by the primary care team for a patient with multiple chronic conditions.
Ongoing care management and coordination.
APCM CPT/HCPCS Codes : G0557
Monthly.
Ongoing care management and coordination for patients under an APCM plan.
Enhanced team-based management for high-risk patients.
APCM CPT/HCPCS Codes : G0558
Monthly.
Enhanced team-based management for high-risk or complex patients.
Who can provide the service?
Physicians
Nurse practitioners
Physician assistants
Clinical staff under direct general or direct supervision, depending on CMS guidelines.
Multidisciplinary teams supporting population health and quality reporting.
Potential Benefits:
Improved chronic disease management.
Stronger patient-provider relationships.
Reduced avoidable hospitalizations.
Enhanced ability to succeed in value-based payment models.
How OnCare360 Can Help:
Structured workflows for APCM documentation and compliance.
Automated reports to meet CMS and payer requirements.
Integrated patient engagement tools (surveys, questionnaires, education).
Task and alert systems to ensure care coordination is timely.
Analytics dashboards for monitoring performance and quality measures.
