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2026 BILLING CODES

CCM, PCM, APCM & APCM BH Add-Ons

Practices that use Phamily can generate $400-700K in annual revenue per 1,000 patients.

CCM Codes Description Reimbursement
99490
  • First 20 minutes of chronic care management performed by clinical staff
  • Care plan established and regularly reviewed
$66.46
99439
  • Additional 20 minutes of CCM services
$50.69
PCM Codes Description Reimbursement
99426
  • First 30 minutes of principal care management performed by clinical staff
$68.14
99427
  • Additional 30 minutes of PCM services
$54.38
APCM Codes Description Reimbursement
G0556
  • Level 1 APCM Complexity: Patients with 1 or fewer chronic conditions
$16.45
G0557
  • Level 2 APCM Complexity: Patients with 2 or more chronic conditions
$54.04
G0558
  • Level 3 APCM Complexity: Patients who are Qualified Medicare Beneficiaries (QMB) and have 2 or more chronic conditions
$117.82
APCM BH Add-Ons Description Reimbursement
G0568
  • Initial month of CoCM (Collaborative Care Model) services delivered to patients also receiving APCM services
$162.47
G0569
  • Additional CoCM services
$146.69
G0570
  • General BHI (Behavioral Health Integration) Services delivered to patients also receiving APCM services
 
 

 
$58.07

Stop doing work for free.

Your practice is already doing many activities that qualify for Medicare CCM reimbursement.

Admin Activities

  • Medical refills
  • Prior authorizations
  • Chart reviews
  • Chart preparation
  • Chart updates
  • Lab reviews

Care Coordination

  • Referrals
  • ER follow-up
  • Discharge follow-up
  • Communication with providers

Care management

  • Phone calls
  • Text messages
  • Voicemails
  • Follow-up
  • Symptom Management
  • Triage and care

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