What APCM is
APCM pays primary care practices a monthly amount for ongoing care management, without counting minutes. G0556 is for patients with zero or one chronic condition, about $16 in 2026. G0557 is for two or more, about $54. G0558 is for two or more plus Qualified Medicare Beneficiary status, about $117. These are national non-facility amounts.
Consent is required once, before billing starts. It can be verbal or written and must be documented. The patient must hear that cost-sharing applies, that only one clinician can bill APCM per month, and that they can stop anytime. The same practitioner cannot bill APCM with CCM, PCM, or TCM for that patient that month.
For 2026, CMS added three behavioral health add-on codes. G0568 and G0569 cover psychiatric Collaborative Care Model services, and G0570 covers general behavioral health integration. They are billable only when the same practitioner reports the APCM base code that month. Required service elements include 24/7 access, an electronic care plan, and care transitions support.