Software for running an APCM program

Not by the same practitioner in the same month. Under the CY 2025 PFS final rule, the practitioner billing APCM cannot also bill CCM, PCM or TCM for that patient that month; another practitioner may, when medically necessary. RPM and RTM can be billed alongside. This is engineering context, not billing advice: confirm with your compliance advisor.

Not for the APCM code itself: CMS states APCM is not time-based. Time still matters when the same patient also receives time-based services such as RPM or RTM, because CMS allows them alongside APCM only if time and effort are not counted twice. We keep both in one record rather than two tools.

CMS's APCM page says auxiliary personnel can be employees, leased employees or independent contractors of the billing provider, working under general supervision and incident to that provider's services. We build for either arrangement, with each practice's patients and staff in a separate tenant where needed. Confirm your arrangement with your compliance advisor.

APCM codes took effect in 2025, and our published engagement is a CCM/PCM platform. What carries over are the patterns APCM needs: patient rosters, role-based access, audit trails, monthly reporting and multi-tenant separation, all in production on that platform. We keep that distinction clear, and the case study shows the details.

CMS requires APCM practices to measure and report performance, either by reporting the Value in Primary Care MIPS Value Pathway or by taking part in one of the Medicare ACO or primary care models it lists. The software holds the underlying data and produces the exports those reports need; the reporting follows each program's own rules.

Yes. We sign a Business Associate Agreement (BAA) before any PHI access: no one on our team sees protected health information until it is executed. APCM records hold consent, conditions and care details, so the BAA comes first. We can sign your organization's BAA or provide ours; our HIPAA BAA page explains what it covers.

Cost depends on scope, so we don't quote a generic range. Book a free 30-minute consultation: we review your requirements and workflow, then send a written scope and quote tied to what you actually need. An APCM layer can be scoped on its own or as a phase of a wider care-management platform.

You do: you own the source code on final payment, and your patient and billing data stay yours throughout. After launch you can keep working with us, bring development in-house or hand the codebase to another team. The same applies to the platform in our case study, which belongs to that client, not to us.