{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T19:39:59Z","timestamp":1792697999594,"version":"4.5.0"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Healing Works Foundation"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J GEN INTERN MED"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In January 2025, Medicare introduced Advanced Primary Care Management (APCM) fee codes, the most substantial of recent Medicare reforms intended to better value the work of comprehensive primary care and lower administrative barriers to uptake of new codes. The highest tier APCM code could potentially bring more than $1200 annually per beneficiary in additional Medicare payment to a primary care practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess uptake of APCM codes by primary care clinicians.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional survey administered in December 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>\n                      Convenience sample of US primary care clinicians in patient care (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009404).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Measures<\/jats:title>\n                    <jats:p>Self-reported use of APCM codes and reasons for not-using.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Results<\/jats:title>\n                    <jats:p>60 respondents (14.9%) reported using APCM codes, 176 (43.6%) were non-users who reported that they had never heard of APCM codes, and 168 (41.6%) were non-users who reported a specific barrier to billing APCM codes. Among the 168 respondents reporting barriers to use, the most frequently cited administrative barriers were not understanding documentation required (53.0%), EHR issues (38.1%), and administrative burden (33.3%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although substantial increases in revenue are now available to primary care clinicians serving Medicare beneficiaries by appropriately billing for APCM services, a relatively small proportion of this national sample of primary care clinicians used APCM codes during the first year of availability. Our results suggest a major opportunity for Medicare, healthcare organizations, and professional societies to educate and coach clinicians to overcome the relatively low administrative barriers to appropriately billing APCM codes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11606-026-10949-8","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T18:52:34Z","timestamp":1792695154000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Primary Care Clinician Uptake of Medicare Advanced Primary Care Management Billing Codes"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7809-214X","authenticated-orcid":false,"given":"Kevin","family":"Grumbach","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Conor M. C.","family":"Duffy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha","family":"Gonzalez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kurt C.","family":"Stange","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Greiner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca S.","family":"Etz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,22]]},"reference":[{"issue":"24","key":"10949_CR1","doi-asserted-by":"publisher","first-page":"2596","DOI":"10.1001\/jama.2018.16116","volume":"320","author":"SD Agarwal","year":"2018","unstructured":"Agarwal SD, Barnett ML, Souza J, Landon BE. Adoption of Medicare\u2019s transitional care management and chronic care management codes in primary care. JAMA. 2018;320(24):2596\u20132597. https:\/\/doi.org\/10.1001\/jama.2018.16116.","journal-title":"JAMA."},{"issue":"1","key":"10949_CR2","doi-asserted-by":"publisher","DOI":"10.1016\/j.outlook.2022.12.001","volume":"71","author":"A Annis","year":"2023","unstructured":"Annis A, Hong HG. Utilization of Medicare\u2019s chronic care management services by primary care providers. Nurs Outlook. 2023;71(1):101905. https:\/\/doi.org\/10.1016\/j.outlook.2022.12.001.","journal-title":"Nurs Outlook."},{"issue":"2","key":"10949_CR3","doi-asserted-by":"publisher","first-page":"564","DOI":"10.1007\/s11606-020-06232-z","volume":"36","author":"JD Brown","year":"2021","unstructured":"Brown JD, Urato C, Ogbuefi P. Uptake of Medicare Behavioral Health Integration Billing Codes in 2017 and 2018. J Gen Intern Med. 2021 Feb;36(2):564-566. https:\/\/doi.org\/10.1007\/s11606-020-06232-z.","journal-title":"J Gen Intern Med."},{"issue":"1","key":"10949_CR4","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.19571","volume":"3","author":"LM Marcotte","year":"2020","unstructured":"Marcotte LM, Reddy A, Zhou L, Miller SC, Hudelson C, Liao JM. Trends in utilization of transitional care management in the United States. JAMA Netw Open. 2020;3(1):e1919571. https:\/\/doi.org\/10.1001\/jamanetworkopen.2019.19571.","journal-title":"JAMA Netw Open."},{"key":"10949_CR5","unstructured":"Analysis of 2019 Medicare Fee-for-Service (FFS) Claims for Chronic Care Management (CCM) and Transitional Care Management (TCM) Services. 2022. 2025. Available at https:\/\/aspe.hhs.gov\/sites\/default\/files\/documents\/31b7d0eeb7decf52f95d569ada0733b4\/CCM-TCM-Descriptive-Analysis.pdf. 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The study protocol was reviewed by the Virginia Commonwealth University Institutional Review Board and deemed exempt.","order":1,"name":"Ethics","label":"Ethics Approval and Consent to Participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Kevin Grumbach serves on the National Academies of Sciences and Medicine Standing Committee on Primary Care; the Committee has issued reports in response to Centers for Medicare and Medicaid Services (CMS) Requests for Information that have addressed Medicare proposed rules for APCM payments. Ann Greiner has authored responses to CMS RFIs on behalf of the Primary Care Collaborative that have addressed proposed APCM payment rules.","order":2,"name":"Ethics","label":"Conflict of Interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":3,"name":"Ethics","label":"Clinical Trial Number","group":{"name":"EthicsHeading","label":"Declarations"}}]}}