Transparent APCM Pricing

Scale Your APCM Program WithConfidence

No setup fees. No long-term contracts. See what Medicare reimburses at each APCM level — then book a free estimate for your practice.

Level 1
Average reimbursement
$15.20G0556

Medicare assigns G0556 when the patient has one or fewer chronic conditions.


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Most common
Level 2
Average reimbursement
$48.84G0557

Medicare assigns G0557 when the patient has two or more chronic conditions and does not meet the QMB criteria for G0558.


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Level 3
Average reimbursement
$107.07G0558

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.

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Real results from practices using AI-powered patient engagement to transform care delivery and revenue.

Frequently Asked Questions

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.

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.

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.

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.

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.

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$0 setup fees. No long-term contracts. 100% HIPAA compliant. Live in under 30 days.

Reimbursement - APCM Billing Plans | Tile Health