Run your APCM program. Automatically.
Droxi™ Unlock helps your practice capture the recurring monthly revenue Advanced Primary Care Management (APCM) was built to pay.
It flags eligible Medicare patients from your own chart data, drafts the care plan the program requires, and drives ongoing patient engagement to keep enrollment active - all inside your EHR, with final review always in your care team’s hands.
See Droxi Unlock in action
A short product demo.
What APCM is
Advanced Primary Care Management is a CMS Medicare program that launched January 1, 2025. It pays a set amount every month for each enrolled patient whose ongoing care your practice manages - turning care coordination into predictable, recurring revenue.
What APCM pays
A flat monthly amount per enrolled patient, tiered by care complexity (2026 national rates, which vary by locality):
~$16/mo
G0556
One chronic condition or fewer
~$54/mo
G0557
Two or more chronic conditions
~$116/mo
G0558
Qualified Medicare Beneficiaries, complex needs
Because the payment recurs every month for every enrolled patient, the numbers add up: a 200-patient panel at the mid-tier rate can represent six figures in new annual revenue. Actual results depend on your panel’s eligibility mix.
Who qualifies
APCM is open to any primary care practice that bills Medicare - from solo and two-provider practices to larger groups and FQHCs, and across MDs, DOs, NPs, and PAs. You do not need to be in an ACO or a special value-based model. Droxi Unlock supports athenahealth practices today, and eClinicalWorks early access is open now - practices have already signed on, and you can join them.
How Droxi Unlock works
1. Patient identification & eligibility
Flags which Medicare patients qualify, reading your existing EHR chart data.
2. Consent & outreach
Manages patient outreach, electronic consent, and enrolled-patient status.
3. Care plan generation
Drafts and helps you manage each patient’s care plan, fully editable by your team.
4. Billing support
Streamlines coding and documentation for G0556 / G0557 / G0558. Your team reviews and approves every item - nothing is auto-submitted.
5. Patient engagement
Helps your team keep patients informed about their care between visits.
Your team stays in control - every plan, summary, and billing item is reviewed and approved by your practice. Not an automated black box.
Why it matters
APCM is more than a revenue line - it gives your practice the resources to stay connected with Medicare patients who benefit most from proactive, ongoing care but are hardest to reach through traditional visit-based models.
Traditional reimbursement was never designed to sustain the proactive, between-visit care these patients need, and the documentation burden kept most practices from pursuing the programs that tried. APCM changes both: it pays your practice for ongoing care management, and enrolled patients gain coordinated, 24/7 access to their care team between visits. Droxi™ Unlock removes the admin burden so you can actually deliver it.
Ready to turn APCM into recurring revenue?
Book a 15-minute call and we’ll show you Droxi™ Unlock running inside your EHR.