Survey Finds Low Uptake of Medicare Advanced Primary Care Management Codes

A cross-sectional survey of 404 US primary care clinicians found that 14.9% reported using Medicare’s Advanced Primary Care Management (APCM) billing codes in their first year. Lack of awareness and administrative barriers were common among non-users.

14.9% of surveyed clinicians reported using APCM codes.
43.6% of respondents had never heard of the codes.
Documentation questions were the most commonly reported barrier.

Medicare introduced Advanced Primary Care Management (APCM) billing codes in January 2025 to support comprehensive primary care. Researchers assessed uptake in a cross-sectional survey administered in December 2025 to a convenience sample of 404 US primary care clinicians providing patient care. The survey asked whether clinicians used the codes and, if not, about reasons for non-use.

Sixty respondents (14.9%) reported using APCM codes. Of the 344 non-users, 176 (43.6% of all respondents) said they had never heard of the codes, while 168 (41.6%) reported a specific barrier. Among those citing barriers, the most common were not understanding the required documentation (53.0%), electronic health record issues (38.1%), and administrative burden (33.3%). The highest-tier code could potentially provide practices with more than $1,200 annually per beneficiary in additional Medicare payment, according to the source.

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Source

Journal of General Internal Medicine: Primary Care Clinician Uptake of Medicare Advanced Primary Care Management Billing Codes ↗

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