AdvancedMD APCM Billing Code Setup Checklist

Navigate to Master Files > Procedure Codes to add G0511 and G0512 with appropriate descriptions for APCM services.

Modify your fee schedule in AdvancedMD to reflect the most recent CMS reimbursement rates for APCM codes.

Assign new APCM codes to specific revenue centers for granular financial reporting and tracking within the billing module.

Ensure that modifiers like -25 or -57 are active in your Master Files for concurrent office visit billing alongside APCM.

Use the AdvancedMD claim inspector to create rules that flag missing documentation for APCM codes before submission.

Configure the AdvancedMD SQL Report Builder to identify patients with two or more chronic conditions eligible for APCM.

Use the Patient Alerts feature to create a visual indicator for front-desk staff when an APCM-eligible patient calls.

Schedule weekly batch insurance verification to confirm coverage for G-codes across your Medicare and Medicare Advantage patient base.

Run a demographics report to ensure mobile numbers and emails are current for AI-driven outreach campaigns.

Create a custom field in the Patient Profile to track the date and status of verbal or written APCM consent.

Connect the AI platform to your AdvancedMD scheduler to allow automated booking of initial APCM enrollment calls.

Set up AI call handling to document patient needs after-hours, satisfying CMS requirements for 24/7 access to care.

Provide the AI with scripts that explain APCM benefits and costs, ensuring consistent messaging during outbound outreach.

Program the AI to perform monthly status checks, documenting the interaction directly back into AdvancedMD notes.

Use API integration to push AI-generated call summaries into the AdvancedMD EHR as non-clinical notes for billing support.

Create specific EHR templates that include mandatory fields for time spent and care coordination activities.

Ensure all APCM-related notes are automatically linked to the patient's master Care Plan within AdvancedMD.

Verify that medication changes discussed during APCM calls are updated in the AdvancedMD pharmacy module.

Establish a monthly process to review EHR audit logs, verifying that non-face-to-face time meets billing thresholds.

Utilize the AdvancedMD patient portal to distribute and collect electronic signatures for APCM enrollment agreements.