Advanced Primary Care Management Software For High-Volume Primary Care Panels

ChronicCareIQ helps high-volume Medicare practices organize patients by APCM complexity level, prioritize follow-up across the panel, and capture monthly reimbursement without building workflows around time-tracking thresholds.

4.8

800+ unsolicited patient reviews

What is Advanced Primary Care Management?

Advanced Primary Care Management is a CMS initiative effective January 2025 that consolidates elements of CCM, PCM, TCM, and communication-based services into a population-based model. APCM reimburses practices across a patient panel using three complexity-based tiers instead of monthly time thresholds.

All primary care patients are grouped into APCM levels based on complexity:

Level 1 for those with no or one chronic condition
Level 2 for those with two or more chronic conditions
Level 3 for Qualified Medicare Beneficiaries with two or more chronic conditions.

It ranges from around $16/month for Level 1 to around $117/month for Level 3 per patient, plus behavioral-health add-ons. See the full breakdown below.

Primary Care Panels Are Too Complex For One-Off Program Workflows

Primary care teams are managing larger and more complex panels, more behavioral-health needs, and more between-visit follow-up than ever. But traditional care-management programs often require teams to manage separate workflows, time thresholds, documentation rules, and patient lists.

APCM can help practices move from one-off program management toward more proactive, panel-based primary care.

How ChronicCareIQ Simplifies APCM

ChronicCareIQ helps practices operationalize APCM around patient complexity, follow-up needs, documentation, and reimbursement.

Organize Patient Populations by APCM Level

Segment patient panels by complexity level and support enrollment without the need for monthly time tracking.

Prioritize Population-Level Follow-Up Needs

RiskIQ automatically detects rising critical-event risk in APCM patients, helping care teams prioritize who needs attention right now.

Simplify APCM Reimbursement

ChronicCareIQ captures qualifying care activity and organizes audit-defensible documentation as your team follows up.

Leverages the EHR, phone systems, and connected devices your practice already uses.

Why Care Management Programs Fail As They Grow

How Much Do APCM
CPT Codes Reimburse?

CPT Code

What it covers

Level / requirement

Est. monthly reimbursement*

G0556

APCM — Level 1

0–1 chronic condition

~$16

G0557

APCM — Level 2

2+ chronic conditions

~$53

G0558

APCM — Level 3

QMB with 2+ chronic conditions

~$117

G0568

Add-on: psychiatric collaborative care (initial)

First month

~$161

G0569

Add-on: psychiatric collaborative care (subsequent)

Subsequent month

~$146

G0570

Add-on: behavioral health care management

Per calendar month

~$57

**Estimated 2026 national non-facility Medicare reimbursement. Actual reimbursement varies by geography, payer, site of service, patient eligibility, documentation, and billing circumstances. This content is educational and is not billing, coding, or legal advice.

See Your Reimbursement Potential

Enter your NPI and we'll estimate the recurring monthly revenue your practice could generate from APCM and other programs — based on your real patient population.

Designed to support scalable primary care operations

“ChronicCareIQ has given us the ability to pay for the robust care team we need to do modern primary care by automatically capturing the appropriate codes and reimbursement dollars.”

Dr. Carl DeMars, Senior Medical Director, Mid Coast Medical Group

APCM Is Built For Primary Care Panels

APCM organizes whole-panel, population-based primary care under one monthly model with no time thresholds. See how it fits your practice.

Cardiology

Identify meaningful cardiac changes sooner through connected-device readings, symptom tracking, and condition-specific monitoring protocols.

Pulmonology

Track respiratory health between visits through oxygen saturation trends, symptom reporting, inhaler adherence, and treatment response.

Primary Care

Monitor chronic conditions between visits through symptom reporting, blood pressure, glucose, weight, mood, and medication adherence trends.

Nephrology

Monitor kidney health through blood pressure trends, fluid and weight tracking, symptom reporting, and medication adherence.

Neurology

Track neurologic symptoms, mobility changes, medication adherence, and functional status through structured assessments and monitoring.

Gastroenterology

Support ongoing behavioral health care through mood screening, medication adherence monitoring, risk assessment, and condition-specific protocols.

Behavioral Health

Support ongoing behavioral health care through mood screening, medication adherence monitoring, risk assessment, and condition-specific protocols.

Multi-Specialty

Manage multiple chronic conditions from one platform with symptom tracking, medication adherence monitoring, and specialty-specific care protocols.

When Patients Engage, Care Programs Scale

4.8 stars. 800+ patient reviews. Every rating below is unsolicited.
No incentives. No campaigns.

4.8

4.8

ChronicCareIQ has helped tremendously in keeping in touch with our patients on a constant and recurrent basis. It has also helped us improve our quality scores, decrease our emergency room utilization, and also decrease hospitalizations.

Dr. Salma SaigerInternist, Salma Mazhar MD PA Primary Care Clinic

Doctors are not going to be able to live without ChronicCareIQ. The convenience and regular contact with patients is the big key going forward.

Dr. Gary P. JonesThoracic Surgeon, Louisiana Cardiovascular & Thoracic Institute

As a healthcare provider committed to delivering the highest quality of care, ChronicCareIQ has become an indispensable ally in our mission. The platform's impact on patient outcomes, from reducing hospital admissions to enhancing communication and achieving financial success, has exceeded our expectations.

Dr. Jim Carmical MDPrimary Care Physician, Woodside Medical

I’ve really been pleased with our patient retention rate with ChronicCareIQ. Patients are very thankful for it and want to continue using it.

Dr. Brian FlowersCardiologist, Birmingham Heart Clinic

At Chesapeake & Washington Heart Care, we've seen remarkable improvements with ChronicCareIQ. It has greatly enhanced the efficiency of our phone interactions and the promptness in updating patient care. This has been vital in providing timely and effective healthcare services to our patients.

Gina Baxter Chief Operating Officer, Chesapeake and Washington Heart Care

With ChronicCareIQ, we are better in touch with our patients, and patients feel better knowing that they have daily or regular contact with our office. We have also seen a significant decrease in office call volume.

Dr. James WestInternist, Perimeter North Internal Medicine

ChronicCareIQ has helped tremendously in keeping in touch with our patients on a constant and recurrent basis. It has also helped us improve our quality scores, decrease our emergency room utilization, and also decrease hospitalizations.

Dr. Salma Saiger Internist, Salma Mazhar MD PA Primary Care Clinic

FAQ

How is APCM different from CCM?

APCM is a monthly, panel-based model that assigns patients to complexity levels and does not require monthly time thresholds. CCM is a time-based care-management model for patients with two or more chronic conditions. ChronicCareIQ helps practices evaluate which model fits their patient population, workflows, and reimbursement strategy.

What does “seen by the billing provider” mean for APCM?

APCM eligibility may depend on whether the patient has had a qualifying visit with the billing provider within the required timeframe. Practices should confirm current CMS and payer requirements before billing.

Which practices are a strong fit for APCM?

APCM is especially relevant for primary care and multispecialty practices managing large Medicare patient panels, chronic conditions, behavioral-health needs, and recurring between-visit follow-up.

How are patients assigned to APCM levels?

Patients are organized by complexity level based on chronic condition count and QMB status. Practices should confirm eligibility, visit history, documentation, and payer rules before billing.

Does APCM require monthly time tracking?

APCM does not use the same monthly time thresholds as CCM or PCM, but practices still need documentation that supports eligibility, care activity, and billing.

Can APCM be used with CCM, PCM, BHI / CoCM, RPM, or TCM?

APCM may overlap with other care-management programs, but billing depends on patient eligibility, payer rules, timing, documentation, and avoiding duplicate or incompatible billing. ChronicCareIQ helps organize program activity so practices can evaluate the right model.

Build a modern,  Scalable APCM program