Consent Updates Demo in UI
The user interface has been updated to support multiple consents and historical tracking of consent actions. See our Consent Demo within ChronicCareIQ here!
ACPM – Demo Link and Code information
Advanced Primary Care Management (APCM) codes for 2025 are now available to clients who are the focal point of all needed health care and responsible for the primary care of a patient. These codes are based on set of service elements and not time based.
Service Elements of APCM:
The service elements of APCM are not required to be completed on every patient every month – CMS states only “some” of these elements are necessary for billing. However, the practice/site MUST be able to offer all of these elements within practice scope, even if they do not perform them every month. If not ALL of these service elements can be offered to patients – the practice should NOT bill APCM.
Specific Resources for QMB-only Qualified Patients:
APCM specifically designates QMB-only patients as eligible for the G0558. This is a sub-set of dual eligible enrollees, not all of them. Since this QMB-only program is a very specifically outline program by Medicare, here are some resources for helping understand and identify QMB-only patients:
The database managed by Medicare to properly identify QMB patients is called HETS (HIPAA Eligibility Transaction System). Providers must register for HETS and have access to this information to bill APCM:
New Global Account Billing Settings Available
Two Diagnosis Requirement for CCM billing
ChronicCareIQ offers the ability to require two diagnosis codes be listed in a patient’s ChronicCareIQ chart in order to drop CCM codes. When this global billing setting is applied for a client, any patient that does not have at least two diagnosis codes in the chart will not be eligible for billing:
This custom rule for enhanced compliance for your program can be turned on by ChronicCareIQ support – please contact [email protected] to have this rule enabled.
NOTE: APCM enabled accounts are REQUIRED to have this rule in effect. If your practice/site is billing APCM, this rule is automatically in effect.
Care Plan Requirement for CCM Billing
ChronicCareIQ also can enhance compliance in your program by requiring the care plan is marked within the system in order to drop CCM billing. Contact [email protected] to have this custom rule enabled:
