CPT Payments for APCM, CCM, and PCM
Amounts vary by payer and locality; we provide current references during onboarding. Required elements are captured to support payment integrity.
APCM Amounts
We share current references for your region and payers. Updates are reviewed during regular check-ins and quarterly reviews.
CCM Amounts
Codes include base and add-on minutes by thresholds. Utilization is mapped to accurate tiers each cycle.
PCM Amounts
Single-condition services follow specialty-specific CPT guidance. Allowables are monitored and flags are escalated promptly.
Nuances & Oversight
Payment rules can change and differ by plan; our team watches closely. Providers maintain oversight with concise summaries and sign-offs.
Payer Nuances
Local coverage and plan rules are tracked and documented. We flag updates and adjust SOPs to keep claims clean.
Required Elements
Consent, eligibility, care-plan elements, and time are captured. Templates ensure the minimum necessary is recorded correctly.
Provider Oversight
Supervising clinicians review and attest monthly with clarity. The review process is streamlined and defensible.