If your practice adopted APCM by shutting down RPM and RTM programs, you left money on the table. If you're running all three programs separately, you're burning cash on duplicate documentation and exposing yourself to compliance risk...
Advanced Primary Care Management (APCM) represents one of the more meaningful changes in the CMS Physician Fee Schedule. As of January 1, 2025, practices that adopt this model will be reimbursed through monthly, risk-stratified codes rather than only episodic, time-based billing...
The Federal Trade Commission’s Sept. 12 warning to healthcare employers is a simple message with real operational consequences. Overbroad noncompetes, no‑poach language, and “de facto” restraints chill worker mobility and can limit patients’ ability to choose their clinicians. For practices building Advanced Primary Care Management teams, restrictive templates do more than create legal risk...
Advanced Primary Care Management represents Medicare's most ambitious attempt to transform primary care economics. Unlike previous programs that nibbled at the margins, APCM fundamentally restructures how practices organize, deliver, and bill for comprehensive care...
Advanced Primary Care Management (APCM) is Medicare’s newest program, introduced in 2025 with three billing codes: G0556, G0557, and G0558. This represents a pivotal shift toward value-based primary care by offering monthly reimbursements for delivering continuous, patient-focused services. You're already providing these services—why not get paid for it?
At 2 AM, a new mother in rural Alabama feels her heart racing. She's two weeks postpartum, alone with a newborn while her husband works the night shift. Her blood pressure reading on the home monitor shows 158/95. Within minutes, her care team receives an alert. By 6 AM, a nurse has called, medications are adjusted, and what could have been a stroke becomes a story of crisis averted.
Many health systems pay full-service RPM vendors $40–$80 PMPM for services they can in-source for far less. With 2025 Medicare rates and OIG scrutiny, it's time to revisit the build-vs-buy math.
A few months ago, a physician at a 12-doctor practice in rural California called me frustrated. His practice was hemorrhaging money on readmissions, his nurses were burning out from phone tag with chronic disease patients, and his administrator was getting pressure from...
Medical executives today face an uncomfortable reality: while navigating shrinking margins and mounting operational pressures, many are unknowingly surrendering millions in Medicare reimbursements to third-party vendors. The culprit? Poorly structured Remote Patient Monitoring (RPM), Chronic Care Management (CCM)...
If you've spent any time managing a remote patient monitoring (RPM) program, you already know the drill: juggling the 16-day rule, keeping track of clinical minutes, chasing compliance, and often wondering if this is really what patient-centered care was meant to feel like...