Cardiology APCM Revenue Calculator | TileHealth
Estimate your cardiology practice's revenue from APCM codes G0557 and G0558. See how AI-powered monitoring scales heart failure care coordination.
Determine the financial impact of implementing Advanced Primary Care Management (APCM) for your cardiology practice. Heart failure and CAD patients are high-value candidates for G0557 and G0558 codes. Use this calculator to see how AI-driven outreach can scale your revenue.
Your Numbers
Patients with 2 or more chronic conditions (e.g., Heart Failure, CAD, AFib) qualifying for APCM.
Percentage of eligible patients successfully enrolled and monitored via AI-assisted outreach.
Blended Medicare rate for G0557 (~$75) and G0558 (~$135) based on patient complexity.
Projected gross monthly revenue from APCM billing.
Total annual revenue potential before operational expenses.
How this calculator works
The calculator multiplies your eligible cardiac patient panel by your target enrollment rate and the projected 2026 Medicare reimbursement for APCM codes G0557 and G0558 to provide a gross revenue projection.
Assumptions- Reimbursement rates are based on 2026 national Medicare averages for G0557 and G0558.
- Patients meet the CMS requirement of having two or more chronic conditions.
- AI-driven outreach ensures the 20-minute monthly coordination threshold is met.
- Calculations assume a 100% success rate in monthly documentation and billing submission.
Frequently Asked Questions
This calculator focuses on G0557 (Moderate Complexity APCM) and G0558 (High Complexity APCM), which are ideal for specialists managing heart failure and complex arrhythmias.
AI automates the 20 minutes of non-face-to-face care coordination required monthly. This allows practices to scale from 50 to 5,000 patients without hiring additional clinical staff.
Yes, APCM covers the chronic care coordination and management of the patient's condition, which is distinct from the technical and supervised exercise components of cardiac rehabilitation.
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