Primary care providers are the unsung heroes of the healthcare system—answering after-hours calls, coordinating with specialists, adjusting medications, and ensuring patients don’t fall through the cracks. But until recently, most of that work went uncompensated.
That’s now changing.
Thanks to Advanced Primary Care Management (APCM), a new CMS payment model introduced in 2023, primary care practices can finally get paid for non-office-based care coordination and chronic care support. The program offers recurring monthly revenue, simplified billing requirements, and a chance to monetize the work your team is already doing.
In this blog, we’ll explain APCM, who qualifies, how it compares to traditional Chronic Care Management (CCM), and why early adopters have a strategic advantage.
APCM is a CMS initiative designed specifically for primary care practices to receive monthly payments for care provided outside of traditional office visits. This includes services like:
If your practice already supports Medicare patients with multiple chronic conditions, APCM is a way to generate predictable monthly revenue from the work you’re already doing—without adding staff or taking on extra administrative burden.
To qualify for APCM, a patient must:
| Tier | Patient Type | Monthly Payment |
|---|---|---|
| Tier 1 | Medicare with 1+ chronic conditions | ~$15 |
| Tier 2 | Moderate complexity (most common) | ~$50 |
| Tier 3 | High complexity or QMB patients | Up to $110 |
| FQHCs2 | Use G Codes | Alternative billing path |
For many practices, even enrolling 100 eligible patients at the middle tier could result in $60,000/year in added revenue—recurring and scalable.
APCM is often described as a “better version of CCM,” and for good reason. It removes many of the barriers that make chronic care management frustrating for small and midsize practices.
Furthermore, APCM expands the pool of eligible Medicare patients by requiring only one chronic condition, compared to the two required for CCM. It also opens the door for patients without chronic conditions who still need ongoing care management to qualify.
| Feature | CCM | APCM |
|---|---|---|
| Eligible Providers | Any specialty | Primary care only |
| Time Requirements | 20+ minutes/month | No time requirement |
| Consent Needed | Written only | Verbal or written |
| Documentation Burden | High | Low |
| Monthly Reimbursement | ~$62 | $15-$110 |
| Flexibility | Often tied to third-party services | Flexibility Often tied to third-party services Practice-led with software support |
| Billing Specialty | Complex | Billing Simplicity Complex Streamlined 3-tier model |
🩺 Bottom line: CCM walked so APCM could run.
APCM launched in 2025 and awareness remains low among primary care providers. Organizations like the American Academy of Family Physicians have not yet made major efforts to promote it.
According to Dr. Larry Blosser, Chief Medical Officer at ReportingMD and quality care advocate:
“Practices are already doing this work—it’s time they got paid for it.”
At ReportingMD, our mission is to help primary care providers maximize revenue with minimal lift. ReportingMD offers a flexible model that gives practices control over workflows and margins and enables them to participate seamlessly in APCM. Our APCM solution is purpose-built for:
Plus, with our reseller agreement with MD Revolution, we can support any practice—whether they prefer to manage in-house or want a full-service option.
Advanced Primary Care Management is here, it’s simple, and it’s profitable. If your practice is looking for a way to grow revenue by getting paid for the work you are alreay doing, APCM is the answer.
Get a free consultation to learn more about how to implement APCM and begin generating revenue with this value-base care program: