APCM & AWV Implementation Checklist for Primary Care

Use AI to check Medicare status for G0438 or G0439 eligibility before scheduling to prevent claim denials.

Deploy automated voice agents to reach the 50% of patients missing their annual visits and book them instantly.

Include APCM benefit information in the automated AWV appointment reminders to prep patients for enrollment.

Send the HRA via SMS or email prior to the visit to save in-office clinical time and capture data early.

Identify patients with secondary insurance that covers APCM cost-sharing requirements to improve enrollment rates.

Use text and voice automation to reduce no-show rates for high-value AWV appointments.

Ensure HRA questions align with APCM chronic condition identification requirements for seamless transitions.

Incorporate SDOH questions into the AWV to trigger APCM care management flags and intervention needs.

Use the AWV to identify missed screenings that require ongoing APCM follow-up and management.

Draft the initial APCM care plan during the AWV visit to satisfy Medicare billing and clinical requirements.

Obtain and document verbal or written consent for APCM during the AWV encounter for compliance.

Complete a thorough review of medications to identify high-risk patients who qualify for APCM services.

Configure the EHR to allow G0438/G0439 and APCM codes on the same claim when performed together.

Track the $700+ per patient potential by combining AWV and monthly APCM payments in your financial reports.

Ensure the HRA and care plan are timestamped and linked to the AWV date of service for audit protection.

Sync automated outreach records to the patient chart to prove engagement efforts for Medicare compliance.

Link AWV completion rates to MIPS and Value-Based Care performance bonuses to maximize incentives.

Establish a workflow for correcting mismatched AWV/APCM billing codes to ensure steady cash flow.