Medicare coverage
Does Medicare Cover Advanced Primary Care Management?
Yes. Medicare Part B (Medical Insurance) covers Advanced Primary Care Management services to help your doctor and other health care providers coordinate and tailor care to your needs.
Yes: Part B
Source: Medicare.gov, Advanced Primary Care Management services, checked October 23, 2026.
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Coverage at a glance
- Covered?
- Yes
- Which part
- Part B
- What you pay
- After the Part B deductible, you pay 20% of the Medicare-approved amount.
- How often
- Monthly
- Part B deductible 2026
- $283 a year (CMS). Part B premium $202.90 a month.
- Medicare.gov page
- Advanced Primary Care Management services
Description
Advanced Primary Care Management is a patient-focused approach to care. Health care providers who offer Advanced Primary Care Management services take extra steps to actively manage all your health care needs. When you get these services, you and your primary care provider (or care team) agree that they’ll be your main point of ongoing care. They’ll talk to you about your care plan and coordinate all your health care needs, including care you get from other doctors, hospitals, and providers.
Providers that offer these services must provide you with:
- 24/7 access to your care team or provider through the phone, an online portal, email, and virtual check-ins
- Chronic care management
- A personalized care plan that lists your current conditions and treatments
- Comprehensive care coordination to quickly connect you with specialists and other providers
- Transitional care between health care settings (like follow-up are after you're discharged from a hospital)
- Medication management
- Behavioral health integration services (including the Psychiatric Collaborative Care Model)
From Medicare.gov, checked October 23, 2026.
Coverage details
- Check with your primary care provider to make sure they offer these services. Then, give your provider verbal or written consent to be your main point of care for all your health needs. They’ll document your consent on your medical record. You must also have an initial visit with your provider unless:
- You've gone to the provider or another provider in the same practice within the last 3 years.
- You got another type of care management (like chronic care management) from the provider or another provider in the same practice within the last year.
- You can stop getting services at any time. Talk to your provider to stop participating.
Adding providers to your secure Medicare account at Medicare.gov lets you store all your provider contact information in one place. Log into (or create) your Medicare account at any time to add providers and select one as your primary health care provider.
From Medicare.gov, checked October 23, 2026.
Costs
After you meet the Part B deductible, you pay 20% of the Medicare-approved amount. Many people who have both Medicare and Medicaid pay nothing for these services.
If you have a Medicare Advantage Plan, your costs for these services might be different. Contact your plan for specific cost information.
From Medicare.gov, checked October 23, 2026.
How often
Monthly
From Medicare.gov, checked October 23, 2026.
Related pages
- Does Medicare Cover Behavioral Health Integration?
Only in certain cases
- Does Medicare Cover Cognitive Assessments?
Yes
- Does Medicare Cover Chronic Care Management?
Only in certain cases
- Does Medicare Cover Principal Care Management?
Yes
- Does Medicare Cover Transitional Care Management?
Only in certain cases
- Does Medicare Cover Chronic Pain Management?
Yes
- Medicare Part B deductible 2027
- Part D out-of-pocket max 2027
- Dual eligible: Medicare and Medicaid together
- 2027 Medicare plans by county
- Everything Medicare covers, A to Z
Questions
Does Medicare Cover Advanced Primary Care Management?
Yes. Medicare Part B (Medical Insurance) covers Advanced Primary Care Management services to help your doctor and other health care providers coordinate and tailor care to your needs.
Which part of Medicare covers Advanced Primary Care Management?
Medicare.gov lists Advanced Primary Care Management services under Part B.
How much do you pay for Advanced Primary Care Management with Medicare?
Per Medicare.gov: After the Part B deductible, you pay 20% of the Medicare-approved amount.
Does a Medicare Advantage plan cover Advanced Primary Care Management?
Medicare Advantage plans must cover what Original Medicare covers and some offer extra benefits. Check the plan's Evidence of Coverage. Rivvi does not recommend plans.
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Does Medicare Cover Advanced Primary Care Management?
Yes. Medicare Part B (Medical Insurance) covers Advanced Primary Care Management services to help your doctor and other health care providers coordinate and tailor care to your needs.
Checked against Medicare.gov 2026-10-23. Source: Rivvi