Payment for General Care Management Services

230.2.10– Payment for General Care Management Services (Rev. 13600; Issued: 02-20-26; Effective: 01-01-26; Implementation:03-23-26) Advanced Primary Care Management services combine elements of several existing care management and communication technology-based services that include essential elements such as Chronic Care Management (CCM), Transitional Care Management (TCM), and Principal Care Management (PCM). Effective January 1, 2025, RHCs and FQHCs can bill for APCM services once per patient per calendar month using an APCM HCPCS code when the billing requirements are met. APCM services aren’t time based. Effective January 1, 2026, RHCs and FQHCs can bill optional add-on codes for APCM services that would facilitate providing complementary BHI or CoCM services. Detailed information regarding APCM can be found on the CMS Website: https://www.cms.gov/medicare/payment/fee-schedules/physician-fee-schedule/advanced- primary-care-management-services