APCM Care Plan Documentation Checklist for athenaOne

Manually add G0556, G0557, and G0558 to your Practice Fee Schedule to ensure claims are not scrubbed or rejected.

Configure athena's billing rules to prevent denials for concurrent billing of CCM and APCM codes during the same period.

Create specific task classes in athenaOne to track care coordination activities and prioritize APCM outreach for staff.

Connect an AI call center to athenaCommunicator to automate monthly APCM outreach and document results directly in the chart.

Use athena's After Hours documentation fields to prove 24/7 access to the care team, a core requirement for APCM billing.

Use athena's Report Builder to pull a list of patients with two or more chronic conditions and active Medicare coverage.

Ensure patients meet the CMS 'seen within 12 months' criteria by filtering your custom reports by the Last Appointment Date.

Create a custom 'APCM Consent' checkbox in the patient registration or social history tab to track verbal or written opt-ins.

Cross-reference athenahealth Population Health data to find patients missing the required documentation for APCM enrollment.

Map specific Medicare Advantage plans in athena that recognize APCM codes to avoid billing errors for non-covered entities.

Build clinical templates that prompt providers for required elements like goals, prognosis, and medication management status.

Use the Time Tracking feature in athenaOne to document every minute spent on non-face-to-face care coordination activities.

Ensure the patient's problem list in athena is reconciled and updated during every APCM cycle to reflect current health status.

Record all prescription changes, adherence checks, and side effect monitoring within the athenaOne medication module.

Use athenahealth's Patient Portal to share the finalized care plan with the patient, meeting the CMS transparency requirement.