FOR INDEPENDENT PRIMARY CARE PRACTICES
Your Medicare panel already qualifies.
Most of it isn't enrolled.
Medicare's Advanced Primary Care Management codes pay a recurring monthly fee for managing patients between visits — with no time threshold, no stopwatch, no twenty-minute minimum. Most practices qualify. Most don't bill them.
G0556 · G0557 · G0558 — LIVE SINCE 1 JANUARY 2025
ILLUSTRATIVE · EACH MARK IS A MEDICARE PATIENT. FILLED MARKS ARE ENROLLED IN CARE MANAGEMENT TODAY.
WHAT APCM PAYS
Three tiers, one monthly fee, no clock.
$16.37
Patient with 0–1 chronic conditions
$53.77
Two or more chronic conditions
$117.23
Two or more chronic conditions, plus Qualified Medicare Beneficiary status
Per patient, per month. CY2026 national averages — your locality adjustment will differ. Most Medicare beneficiaries carry two or more chronic conditions, so most of a typical panel sits at level 2 or above.
THE ACTUAL OBSTACLE
It isn't a coding problem. It's an information problem.
APCM's service elements depend on things a small practice can't see. Access to the patient's comprehensive record. A care plan maintained against complete information. Coordination with the other clinicians involved. Knowing when your patient was admitted somewhere else, or saw a specialist across town, and acting on it within days.
Those records sit in other health systems, other EHRs, other portals. A practice cannot deliver — or evidence — what it cannot see. That gap is the reason the code exists and mostly goes unbilled.
THE RECORD LAYER
The whole patient, before the visit.
Valinor assembles a patient's records from across every health system, portal and EHR they've used, and returns one unified longitudinal record with a clinical summary your physician reads before the appointment.
“We don't replace your EHR. We make the rest of the patient visible to it.”
Valinor supplies the record layer. Your practice keeps the clinical work and the patient relationship.
IF YOU ALREADY BILL CHRONIC CARE MANAGEMENT
Don't switch. Add a second rail.
Chronic Care Management pays more per patient than APCM does. If anyone has pitched you a migration, they were doing you a disservice. Keep every patient you have on CCM exactly where they are.
The exclusion is per patient per month, not per practice. So the question isn't which code to bill — it's how many of your Medicare patients are currently billing nothing at all. Those go from zero.
SHARED SAVINGS
One piece of work, two payoffs.
If you're in a Shared Savings Program ACO you still bill fee-for-service, so APCM is real incremental revenue. And better management between visits improves total cost of care and quality performance — which is what the shared-savings bonus is calculated on.
DESIGN PARTNER PROGRAMME
Four practices. Ninety days.
We're taking four practices into a paid ninety-day design partner pilot — four because that's how many we can onboard properly.
TERM
Ninety days, paid, invoiced monthly in arrears. Nothing is payable at signature.
PRICING
A flat fee that depends on how many patients you put on the record layer. You'll have the number in the first conversation — there's no quote process and nothing to negotiate.
INCLUDES
Direct access to the founding team, and influence over what gets built.
Fifteen minutes.
Bring your panel size and roughly how many patients are enrolled in care management today. That one number tells us both whether this is worth your time.
Book 15 minutesYou'll be speaking with the founding team, not a sales rep.
SECURITY
Our security assessment completes in August.
We're finishing our HIPAA security programme on Secureframe, with independent assessment to follow in August. Until it's signed off no patient record touches the platform — and in the pilot agreement your start date is tied to that date, so it's a contractual commitment rather than a promise.