Healthmonix Advisor

In 2025, CMS launched a significant evolution in its commitment to primary care: the Advanced Primary Care Management (APCM) codes. These codes — G0556, G0557, and G0558 — are designed to simplify billing, support patient-centered care, and advance health equity for patients with chronic conditions. 

But there’s a catch. These codes come with new requirements, including participation in the Value in Primary Care MIPS Value Pathway (MVP) for eligible clinicians. 

In this post, we’ll break down: 

• What APCM codes are 

• Who can bill them 

• How they differ from existing care management codes 

• What’s required for MIPS compliance 

• What happens if you don’t report 

• What steps your practice should take next 

As value-based care matures, MSSP ACOs face mounting complexity in quality reporting — across EHRs, payers, and evolving CMS requirements. At Healthmonix, we don’t just promise solutions. We’ve already delivered them — at scale, across diverse ACOs, and in direct partnership with forward-thinking healthcare leaders. 

If you’re an eligible clinician participating in MIPS, your 2024 Cost category score will be calculated after submission — and the results may come as a surprise. With Cost accounting for 30% of your total MIPS score, it’s no longer an afterthought. It’s a major factor in your final performance. 

Malvern, Pa. —Healthmonix is proud to announce that the Emergency and Acute Care Clinical Registry (EACCR) has been approved as a Qualified Clinical Data Registry (QCDR) by the Centers for Medicare & Medicaid Services (CMS) for the 2025 reporting year. This is the fifth straight year Healthmonix has earned this designation for EACCR, which empowers clinicians to seamlessly meet Merit-based Incentive Payment System (MIPS) requirements while leveraging innovative tools to drive improvements in patient care and streamline regulatory compliance.

Malvern, Pa. (Jan. 20, 2025) — Healthmonix is proud to announce the release of the 2025 Mental and Behavioral Health Registry (MBHR), a specialized Qualified Clinical Data Registry (QCDR) developed with the American Psychological Association to improve care for individuals with mental and behavioral health conditions. This registry provides healthcare providers with essential tools to track, report, and optimize clinical outcomes in the treatment of mental health and behavioral disorders. 

Malvern, Pa. (Jan. 13, 2025) — Healthmonix is proud to announce the release of the 2025 MIPSpro Enterprise Qualified Clinical Data Registry (QCDR). We’ve updated this cutting-edge registry to provide comprehensive support for a wide range of healthcare specialties, helping providers improve care quality, achieve regulatory compliance, and drive better patient outcomes across various clinical settings. 

The Centers for Medicare & Medicaid Services (CMS) introduced the Melanoma Resection cost measure as part of the Merit-based Incentive Payment System (MIPS). This measure evaluates the cost of care provided during episodes involving the excision of malignant melanoma of the skin or melanoma in situ. 

Malvern, Pa. (Jan. 6, 2025) — Healthmonix proudly announces that MIPSpro and APP Impact have been approved by CMS as a Qualified Registry for the 2025 performance year under the Quality Payment Program (QPP). This designation underscores Healthmonix’s role as a trusted partner for healthcare providers and organizations, enabling seamless participation in Traditional MIPS, MIPS Value Pathways (MVPs), Medicare Shared Savings Program (MSSP) ACOs, and other Alternative Payment Pathways (APPs). 

The Centers for Medicare and Medicaid Innovation (CMMI) have introduced the Making Care Primary (MCP) model, a new initiative aimed at transforming primary care delivery through value-based care.  

 The MCP model, announced June 8, 2023, is a 10.5-year multi-payer partnership launched July 1, 2024. This voluntary model aims to improve care management and care coordination while addressing patients' health-related social needs. 

This year’s HLTH 2024 conference delivered on its promise to push the boundaries of what’s possible in healthcare. It was a chance to connect with peers, challenge the status quo, and dig into the trends that will reshape our industry. From the innovative — but so needed — concept of socially prescribed care to the potential ripple effects of the upcoming election, HLTH 2024 was a window into a rapidly changing landscape.

Here’s what stood out to me.