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CCM vs APCM revenue calculator
Estimate what your practice would bill each month under Chronic Care Management (CCM) versus Advanced Primary Care Management (APCM), using 2026 national Medicare rates. Enter how many enrolled patients you expect at each level. The result is a planning estimate of allowed amounts before locality adjustment, not a billing or payment guarantee.
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| CCM | APCM | |
|---|---|---|
| Time tracking | Yes: 20 min staff (99490), 30 min practitioner (99491), 60 min complex (99487) | No time thresholds; billed per calendar month |
| Conditions | 2+ chronic conditions expected to last 12+ months | Level by condition count (0-1, 2+) and QMB status |
| Consent | Required, documented | Required once before billing starts, documented |
| Same-month limits | One practitioner bills CCM per month | Same practitioner can't also bill CCM, PCM, or TCM that month |
| 2026 add-ons | n/a | Behavioral health add-ons G0568-G0570 with APCM by the same practitioner |
How it's calculated
Each line is patient count times the 2026 national non-facility amount times your locality factor. CCM and APCM totals are shown side by side. These are Medicare allowed amounts, not a payment guarantee.
Questions
Can I bill both CCM and APCM?
Not for the same patient by the same practitioner in the same month. When a patient qualifies for both, the practice chooses which service to report.
Does APCM require tracking minutes?
No. APCM has no time requirement. You must deliver the service elements and have documented consent, and you bill once per calendar month.
What are G0568-G0570?
Behavioral health add-on codes CMS created for 2026, billable with an APCM base code by the same practitioner in the same month: collaborative care initial and subsequent months and general behavioral health integration. Check your MAC for rates.