Medicare AWV & APCM Revenue: FAQ for Primary Care Practices

A compliant HRA must include self-reported information regarding health status, psychosocial risks, activities of daily living (ADLs), and behavioral risks. AI tools can automate the collection of this data prior to the visit to ensure 100% compliance.

While the AWV is a preventive service, APCM is a management service. Medicare allows these to be billed in the same month, provided all documentation requirements for both the wellness visit and the chronic care management components are met.

Medicare Part B covers the AWV at 100% with no copayment or deductible for the patient. This makes it an attractive entry point for patients, who can then be educated on the value of APCM services which may have different cost-sharing structures.

Yes, advanced AI agents can conduct the Health Risk Assessment over the phone before the patient arrives. This saves 15-20 minutes of clinical time during the actual appointment, allowing the provider to focus on the APCM care plan.

Automated outreach ensures consistent contact with the entire Medicare population. AI can identify patients missing their annual visit, offer available time slots, and sync directly with the practice's EHR, removing the burden from front-desk staff.

AI identifies APCM-eligible patients during the AWV scheduling call by checking diagnosis codes. It can then prompt the patient about the program's benefits, ensuring that when they arrive for their AWV, they are already prepared to enroll.