APCM Compliance Guide for Behavioral Health & Psychiatry

Documentation should include standardized tool results (like PHQ-9 or GAD-7), a longitudinal care plan, and evidence of medication management. AI-powered outreach can automate the collection of these assessment scores between visits, ensuring the clinical record is always current for APCM compliance.

Practices must document the review of psychiatric medications, assessment of side effects, and adherence checks. For APCM, this monitoring can be performed via telephonic outreach. Tile's AI call center can conduct these adherence checks and log the responses directly into the patient's record for audit-proof billing.

Yes, Substance Use Disorder (SUD) is recognized as a chronic condition for APCM. Documentation must reflect the ongoing management of the disorder, coordination of recovery services, and monitoring of medication-assisted treatment (MAT) where applicable, often involving more frequent touchpoints than standard psychiatric care.

CMS requires documented verbal or written consent for APCM services. For behavioral health, this must include an explanation of the BHI add-on codes and potential cost-sharing. AI call automation can standardize this consent process, ensuring every patient receives a consistent explanation and their agreement is recorded.

Tile’s AI platform utilizes end-to-end encryption and secure data silos. For behavioral health, this means sensitive psychiatric notes and SUD data are handled with elevated security protocols. The AI only accesses the minimal necessary information required to facilitate the care management call and update the EHR.

While APCM focuses on chronic management, crisis touches must be documented to show care coordination. AI call handling can identify high-risk keywords during patient interactions, immediately escalating the call to a provider while simultaneously documenting the event to support the medical necessity of the APCM care plan.