In 2025, CMS introduced Advanced Primary Care Management (APCM) services to recognize and reimburse the ongoing, often invisible work primary care practices perform between office visits. The codes function as monthly bundled payments designed to support practices that provide comprehensive, relationship-based primary care.
To reduce administrative burden, unlike the Chronic Care Management (CCM) and Principal Care Management (PCM) codes, APCM codes are not time-based, an additional benefit of the codes. They can be used across the array of Traditional Medicare patients in a panel and the three base APCM codes — G0556, G0557, and G0558 — vary by the complexity of the patient. In 2026, CMS built on the APCM code chassis by launching behavioral health APCM add-on codes, G0568 (Initial/first month of Psychiatric Collaborative Care Management (CoCM) services); G0569 (Subsequent months of Psychiatric Collaborative Care Management (CoCM) services); and G0570 (General Behavioral Health Integration (BHI) services).
Because of the structure of Traditional Medicare, the codes bear a 20% cost share. However, the vast majority (about 90%) of Traditional Medicare patients also purchase a Medicare supplementary policy to absorb these costs. Despite this, having even a small portion of patients who are not protected from cost-sharing has slowed the adoption of the APCM codes. However, there are early adopter advanced primary care practices who have demonstrated that successful implementation of APCM codes depends less on adding new clinical work and more on documenting and organizing work practices are already doing, and that open communication with patients is the key to consent and partnership.
The Primary Care Collaborative’s April 28, 2026 webinar, Advanced Primary Care Management: Successful Adopters Tell Their Stories, provided insight from leading practices across the nation who are successfully using APCM codes. The Collaborative will also be devoting its 2026 evidence report to exploring the impact of APCM codes and estimating the expense of waiving the cost-share. The premise is that if greater adoption of APCM produces better outcomes for CMS, then removing the patient cost share would be a wise investment.
Advanced Primary Care Management (APCM) Code Basics
CMS designed APCM to incorporate elements of:
- Chronic Care Management (CCM)
- Principal Care Management (PCM)
- Transitional Care Management (TCM)
- Virtual check-ins
- Digital communications
- Care coordination activities
Practices do not need to provide every APCM element every month. CMS states that required elements must be completed “as clinically appropriate.”
CMS enabled three APCM codes stratified by patient complexity:
- G0556 — Patients with one or fewer chronic conditions
- G0557 — Patients with two or more chronic conditions
- G0558 — Qualified Medicare Beneficiaries (QMBs) with two or more chronic conditions
APCM codes can be billed once per patient per calendar month but cannot be billed concurrently with overlapping codes including transitional care management or complex care management.
The PCC webinar tells the APCM implementation story of Dr. Jason Lofton from Lofton Family Clinic in Arkansas who has 500 Medicare patients. Dr. Lofton has found APCM easier to implement and bill than Chronic Care Management codes and his preliminary data indicates that decreases in both inpatient utilization and emergency department utilization from APCM use. Dr. Lofton’s practice schedules the majority of Annual Wellness Visits (AWV) in January and February and uses it as an opportunity to explain the APCM concept and gain patient consent and finds the majority of his patients are very responsive.
Dr. Sam Hiatt of Community Care of North Carolina (CCNC), a clinically integrated network that provides the lease of pharmacists, nurses, and other clinicians, to practices, especially for practices whose panels are too small to be able to hire resources outright, but would benefit from a partial resource. CCNC focuses on delivering a partnership care team model, especially for rural practices who report that the leased resources are helpful in enabling them to improve outcomes and performance in shared savings models. They also have been helpful in fulfilling the servicing requirements of the APCM codes.
The early adopters who have integrated APCM into their workflows and billing processes also shared some advice for others exploring operationalizing APCM codes. If a practice is already performing population health management, portal messaging, medication reconciliation, and care coordination, it is closer to APCM readiness than it may realize.
Michigan Multipayer Initiatives 