Urology APCM Billing & Enrollment: FAQ Guide

Documentation must show at least 20 minutes of non-face-to-face care coordination. This includes reviewing labs (like PSA or creatinine), adjusting medications for OAB, coordinating with nephrology for stone management, and phone-based symptom monitoring. AI-powered call logs provide time-stamped evidence for these interactions.

APCM can be billed if the chronic care management is for conditions unrelated to the surgical procedure. For example, if a patient is in a global period for a kidney stone procedure, you may still bill APCM for managing their chronic BPH or prostate cancer surveillance, provided the documentation clearly separates the services.

A comprehensive electronic care plan is mandatory. For urology, this should include specific goals like 'reduction in nocturia episodes,' 'maintenance of stable PSA levels,' or 'adherence to metabolic stone prevention protocols.' This plan must be shared with the patient and updated regularly based on monitoring data.

Absolutely. AI systems can trigger automated reminders for 24-hour urine collections, follow up to ensure the patient completed their imaging, and provide hydration reminders. This consistent touchpoint ensures the practice meets the 'continuous care' aspect of APCM without manual staff intervention.

Male patients often under-report symptoms like urinary hesitancy or ED. AI-driven phone systems provide a low-friction, private way for patients to report symptoms via automated prompts. This increases the data available to the urologist and ensures the practice captures the necessary minutes for monthly billing.

Yes, Tile’s AI solutions are designed to sync with major urology EHR platforms. It automatically uploads call transcripts and duration logs, ensuring that the time spent on phone-based chronic care is audit-ready and linked to the correct CPT code for the billing cycle.