Know before you bill
Compliant by construction.
Combining programs incorrectly triggers claim denials and audit risk. This matrix defines exactly which programs can be billed together for the same patient in the same month.
Concurrent billing matrix
Covers the recurring monthly programs. Preventive services (AWV, ACP), post-discharge (TCM) and behavioral health (CoCM) follow their own bundling rules — our team confirms every combination.
| APCM | RPM | CCM | RTM | |
|---|---|---|---|---|
| APCM | — | |||
| RPM | — | |||
| CCM | — | |||
| RTM | — |
Valid concurrent combination Never bill together
Key rules
Two hard exclusivity rules
APCMCCM
Mutually exclusive per patient — a patient is billed under one primary-care management model, never both.
RPMRTM
Mutually exclusive per patient — one monitoring track at a time, physiologic or therapeutic.
Everything else stacks: monitoring layers onto either primary-care model with independent, separate documentation.
Audit red flags
01Billing APCM and CCM for the same patient in the same month
02Billing RPM and RTM concurrently for the same patient
03Shared or copied documentation across concurrent programs
04Missing or undated patient consent
05Time logs that don't meet the program minimum