Planning calculator
Model an Advanced Primary Care Management program before you commit to one
APCM pays a monthly bundled amount per participating patient at one of three levels. Enter your Medicare and Medicare Advantage patient counts, the level mix you expect and your own allowed-amount assumptions to see the gross opportunity - and what it depends on.
- Runs in your browser
- Nothing is sent to Kitronixe
- Aggregate counts only - no patient data
- No sign-up
Advanced Primary Care Management
APCM Revenue Opportunity Calculator
Estimate potential gross reimbursement opportunity for an Advanced Primary Care Management program using your Medicare population, expected participation, the level mix you expect and your reimbursement assumptions.
- Patient population
- Participation
- Program assumptions
- Revenue opportunity
Patient population
Aggregate counts only - never a name, an ID or a diagnosis.
Total Medicare / Medicare Advantage population0
- Potential APCM review population
- 0
- Estimated participating patients
- 0
Level mix
How participating patients are expected to distribute across the current APCM levels. The shares must total 100%.
Level shares total 100%.
Reimbursement assumptions per level
Each level's monthly bundled amount, per payer. Medicare Advantage is entered separately and never assumed equal to Original Medicare.
G0556Level 1 - 0 or 1 chronic condition
No default configured - enter your expected allowed amount to include it.
No default configured - enter your expected allowed amount to include it.
- Estimated patients
- 0
- Estimated monthly opportunity
- $0
G0557Level 2 - 2 or more chronic conditions
No default configured - enter your expected allowed amount to include it.
No default configured - enter your expected allowed amount to include it.
- Estimated patients
- 0
- Estimated monthly opportunity
- $0
G0558Level 3 - 2 or more chronic conditions and QMB status
No default configured - enter your expected allowed amount to include it.
No default configured - enter your expected allowed amount to include it.
- Estimated patients
- 0
- Estimated monthly opportunity
- $0
Your estimated opportunity
Gross reimbursement opportunity - before any cost, never a guarantee.
Combined monthly gross opportunity
$0
Combined annual gross opportunity
$0
Estimated participating patients
0
Avg. monthly amount per participant
$0
- G0556: 0 patients, monthly$0
- G0557: 0 patients, monthly$0
- G0558: 0 patients, monthly$0
- Original Medicare monthly opportunity$0
- Medicare Advantage monthly opportunity$0
Estimated combined monthly gross opportunity $0, annual $0, for 0 participating patients.
- Active Medicare / MA population0
- Potential APCM review population0
- Estimated participating patients0
- G0556 - Level 1 - 0 or 1 chronic condition0
- G0557 - Level 2 - 2 or more chronic conditions0
- G0558 - Level 3 - 2 or more chronic conditions and QMB status0
- Original Medicare$0
- Medicare Advantage$0
Reimbursement assumptionsCMS-derived
- Medicare rate basis
- Not configured - the estimate uses the allowed amounts you enter
- Locality
- Default planning amount where configured, otherwise visitor-entered
- Effective year
- 2026
- Last reviewed
- 2026-09-26
Original Medicare amounts vary by year, locality, service and setting. Medicare Advantage payment and coverage vary by plan, contract and program rules, and are never assumed equal to Original Medicare.
Where this fits
A planning tool, not a service page
Kitronixe supports the operational and billing workflows around care-management programs. APCM bundles elements of chronic care management, transitional care and other services into one monthly code; the practice decides which programs fit which patients, and the clinical work stays with its clinicians.
- Chronic Care Management supportThe monthly workflow around a CCM program, with its own calculator.
- Remote Patient Monitoring supportOperational and billing workflow for eligible RPM programs.
- RCM ServicesEvery revenue-cycle and value-added service, in one place.
- Talk to an RCM specialistWalk through your program, your payer mix and what the estimate leaves out.