Transparent APCM Pricing
Scale Your APCM Program With Confidence
No setup fees. No long-term contracts. See what Medicare reimburses at each APCM level — then book a free estimate for your practice.
Trusted by your healthcare service providers
Level 1
$15.20G0556per patient per month
Average reimbursement per patient per month
Medicare assigns G0556 when the patient has one or fewer chronic conditions.
Get a free estimateLevel 2
Most common$48.84G0557per patient per month
Average reimbursement per patient per month
Medicare assigns G0557 when the patient has two or more chronic conditions and does not meet the QMB criteria for G0558.
Get a free estimateLevel 3
$107.07G0558per patient per month
Average reimbursement per patient per month
Medicare assigns G0558 when the patient has two or more chronic conditions and Qualified Medicare Beneficiary (QMB) status.
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Average reimbursement amounts are national figures; actual payment varies by locality. Which G-code applies is determined by Medicare from chronic condition count and Qualified Medicare Beneficiary (QMB) status—not a physician recommendation.
What’s included
Everything behind the monthly claim
Eligibility review
Your panel reviewed under your BAA.
Enrollment & consent
Calls that explain the program and record consent.
Monthly check-ins
At least one check-in every calendar month.
Monthly billing report
Each patient mapped to the right code.
FAQ
Frequently asked questions
Is this HIPAA compliant?
Yes. All data is encrypted in transit and at rest with AES-256, and we sign a BAA (Business Associate Agreement) with every practice. Records are retained for 7 years to keep you audit-ready.
Does it work with my EHR?
Yes. We integrate with 8+ major EHR systems including Epic, Cerner, Athenahealth, eClinicalWorks, and NextGen to sync patient data and billing codes. Our team runs the full integration, which typically goes live in under 30 days.
How does patient outreach work?
Our agent calls eligible patients to enroll them in APCM, update care plans, and run at least one check-in every calendar month - adding zero workload to your staff while documenting every minute for billing.
What codes can I bill?
You can bill the 2025 APCM codes G0556, G0557, and G0558, tiered by patient complexity. Our system tracks billable time automatically and produces a monthly report mapped to the correct code.
What if a patient has an emergency?
The agent recognizes 'red flag' symptoms in real time. When an emergency is detected, it follows your clinical protocols within seconds to escalate the call to your on-call provider or direct the patient to emergency services.
Ready to turn patient data into passive revenue?
$0 setup fees. No long-term contracts. 100% HIPAA compliant. Live in under 30 days.