ModMed APCM Enrollment Checklist for Specialty Practices

Extract lists of patients with two or more chronic conditions such as Psoriatic Arthritis, IBD, or Chronic Dermatitis using the ModMed Analytics platform.

Ensure identified patients have had an office visit within the last year to meet CMS eligibility requirements for active chronic care.

Add a custom 'APCM Eligible' flag to the patient header in EMA to alert staff during check-in or clinical intake.

Identify patients on long-term biologics or specialty medications that qualify as part of a chronic care management plan.

Verify that the patient's insurance provider recognizes APCM codes and check for specific documentation requirements within ModMed's billing module.

Configure an AI-powered phone system to call eligible patients and explain the benefits of the APCM program in a natural, conversational tone.

Use AI to record and transcribe verbal patient consent, ensuring it meets CMS requirements for non-face-to-face enrollment.

Integrate AI call logs directly into the ModMed 'Communication' tab to maintain a clear audit trail of all enrollment attempts.

Trigger an automated SMS via the AI system to provide patients with digital educational materials regarding their care plan.

Allow the AI assistant to book the first care coordination call directly into the ModMed practice management calendar.

Develop specialty-specific Smart Stamps in EMA that allow clinicians to quickly document chronic care interventions and coordination efforts.

Build a custom APCM Care Plan template in ModMed that includes goals, health status, and medication management sections.

Enable time-tracking macros within ModMed to log the cumulative 20 minutes of non-face-to-face care required for monthly billing.

Ensure the APCM encounter is correctly linked to the active chronic conditions in the ModMed Problem List for accurate coding.

Configure ModMed to automatically share the finalized APCM care plan with the patient via the secure ModMed patient portal.

Add APCM-specific CPT codes (e.g., G0511, 99490) to the ModMed Master Fee Schedule with appropriate specialty-specific rates.

Run a monthly report in ModMed to identify patients who met the 20-minute threshold but have not yet been billed.

Ensure all APCM claims are mapped to the correct specialty provider NPI within the ModMed billing settings to avoid denials.

Use the ModMed RCM dashboard to track any APCM claim rejections and adjust documentation templates accordingly.

Set up a workflow where ModMed generates a 'pending charge' once the AI-tracked time reaches the required monthly minimum.