AdvancedMD APCM Compliance & Audit Readiness Checklist

Add G0511 and G0512 to your AdvancedMD Charge Master with appropriate standard pricing for your region.

Create custom claim scrubbing rules in AdvancedMD to prevent APCM codes from being billed with conflicting CCM or PCM codes.

Ensure APCM codes are correctly mapped to MDs, NPs, or PAs within the AdvancedMD provider setup to satisfy CMS supervision requirements.

Configure AdvancedMD to trigger billing alerts once the AI-tracked 20-minute monthly threshold for APCM is met.

Establish protocols for using Modifier 25 when APCM services occur on the same day as a scheduled E/M visit in AdvancedMD.

Build specific AdvancedMD note templates that include mandatory fields for care plan updates and social determinants of health (SDOH).

Utilize AdvancedMD macros to quickly document non-face-to-face time spent on care coordination and patient communication.

Ensure patient-centered goals are documented in a searchable field within AdvancedMD for easy retrieval during an audit.

Use the AdvancedMD document center to aggregate external specialist notes and community resource referrals related to APCM.

Set up a workflow in AdvancedMD for providers to review and sign off on cumulative monthly care logs at month-end.

Filter AdvancedMD patient lists by diagnosis code (2+ chronic conditions) and insurance type to identify APCM-eligible candidates.

Upload signed consent forms or document verbal consent in the 'Alerts' or 'Notes' section of the AdvancedMD patient chart.

Apply a specific 'APCM Enrolled' patient flag in AdvancedMD demographics to ensure visibility across all staff touchpoints.

Use AdvancedMD's integrated eligibility checking to confirm active Medicare/Medicare Advantage status before each billing cycle.

Cross-reference APCM enrollment dates in AdvancedMD with the first date of service to ensure no pre-consent billing occurs.

Ensure AI-driven patient check-in call transcripts are automatically pushed to the AdvancedMD patient note history.

Set the AI system to automatically initiate monthly APCM check-in calls for all patients flagged as 'Enrolled' in AdvancedMD.

Configure AI to ask specific health status questions and flag responses for provider review within the AdvancedMD task dashboard.

Automatically export the duration of AI patient interactions into the AdvancedMD time-tracking module for APCM G-code support.

Periodically review AI-generated transcripts in AdvancedMD to ensure they meet CMS requirements for substantive care coordination.