Diabetes and heart failure
Consider CCM for medicines, referrals, and a shared plan. Useful home readings may justify a separate RPM assessment.
Contact us FOR YOUR PRACTICE
Primary care
Connect chronic conditions, home readings, transitions, and behavioral-health needs to the patient’s primary-care plan.
RELEVANT PATHWAYS
Which kind of between-visit help do our patients need?
Start with the clinical problem. Choose time-based care management or the full primary-care bundle where appropriate; add monitoring only when its separate clinical and payment requirements fit.
CCM · Chronic Care Management
Multiple qualifying chronic conditions and a whole-person care plan.
Patient example, requirements, and billingAPCM · Advanced Primary Care Management
A practice ready to provide the full longitudinal primary-care model.
Patient example, requirements, and billingRPM · Remote Physiologic Monitoring
Physiologic readings that can inform treatment.
Patient example, requirements, and billingTCM · Transitional Care Management
A qualifying discharge and a practice able to own the transition.
Patient example, requirements, and billingBHI · Behavioral Health Integration
Coordinated behavioral-health follow-up with the appropriate team.
Patient example, requirements, and billingPCM · Principal Care Management
One unusually complex, high-risk condition when disease-specific management fits.
Patient example, requirements, and billingCheck this before choosing a programAPCM requires the full model, including practice-level urgent access and reporting. Purchasing outreach or a device alone does not establish APCM. The agreed PrimeVital staffing hours must be specified separately.
EXAMPLES FOR YOUR SETTING
Start with a real need in your practice.
These scenarios show what to evaluate, rather than automatically assign a program or approve reimbursement.
A primary-care home
Consider APCM when access, coordination, electronic planning, population management, and performance reporting are in place.
Returning from hospital
Assess TCM eligibility and deadlines before assuming the follow-up is a separate transition claim.
ONE ILLUSTRATIVE RPM JOURNEY
See the patient, practitioner, and support roles.
Meet Maria: her primary-care clinician wants a clearer picture of her blood pressure between appointments.
Choose patients
Before enrollment- Patient / caregiver
- Decides whether to join and understands possible costs.
- Treating practice
- Confirms medical need, an established relationship, goals, and the payer pathway.
- PrimeVital’s agreed role
- Coordinates onboarding and consent documentation within the agreed workflow.
- What gets recorded
- Clinical reason, consent, responsible practitioner, and coverage checks.
The sample goal
Understand Maria’s blood-pressure trend and help her follow the treatment plan.
YOUR INVOLVEMENT
Agree on responsibilities before the first patient starts.
Your organization
Your practitioner selects patients, directs the plan, makes treatment decisions, responds to clinical escalations, and approves final documentation and claims.
PrimeVital’s agreed support
The full care arrangement can include applicable devices and a care-management team. We help organize enrollment, follow-up, records, and billing handoffs. Interactly can support front-desk scheduling and messages.
Service hours, professional qualifications, technology, integrations, records access, and fees are confirmed in the engagement. Front-desk automation handles agreed administrative tasks; clinical judgment and claims remain with the responsible qualified professionals.
WHAT YOU NEED TO DO
A practical launch checklist.
- Select patients based on clinical need and payer, not diagnosis counts alone.
- Name the clinical and billing owner; complete initiating visits and consent where required.
- Maintain plans, access arrangements, follow-up, and escalation responsibilities.
- Agree on care-team credentials, supervision, service hours, records access, and billing handoffs.
- Check other practitioners, bundled contracts, and services already paid for.
PAYMENT & FINANCIAL PICTURE
Who gets paid, and what does the practice spend?
The eligible practice submits supported professional claims or follows its payer contract. PrimeVital is paid through its service agreement. CCM and APCM are choices to evaluate, not automatic payments to stack for the same work.
Illustrative RPM model
These starting figures are hypothetical. They are not Medicare rates, a PrimeVital quote, or a payment forecast. Replace them with your verified contract, service mix, and cost assumptions.
Service, device, and practice costs
Illustrative agreement: fees apply to enrolled patients, even if a service does not qualify for payment.
Leave at zero if already included in the service fee. Avoid counting it twice.
Shown separately from recurring operating costs.
35 of 50 patients meet the assumed service requirements.
Collections
$3,500
Operating costs
$2,150
Contribution
$1,350
$1,750 service fees + $0 additional device costs + $400 practice costs.
Contribution is before other overhead and taxes. Actual billing uses service-level evidence and rules; this simplified model does not select codes, approve eligibility, or guarantee outcomes. Patient cost sharing and QMB protections must be checked separately.
BENEFITS TO TRACK
Choose a baseline and a review date.
Agree on the measures that matter to your patients and team.
- Patient participation and care-plan understanding
- Medication/referral gaps resolved
- Clinical trends selected by the practitioner
- Practice workload and actual net collections
Sources and scope
Reviewed October 7, 2026. Practice type alone does not establish clinical eligibility or payment. Detailed program pages maintain the code references; use the patient’s actual payer, professional, setting, and date of service.
YOUR PRACTICE, YOUR PATIENTS
Bring us the workflow you want to improve.
Share your practice type, patient group, payer mix, and current team. We can map the care pathway, available support, launch gaps, and assumptions to verify.
DESIGN A PRACTICAL STARTING POINT
Tell us where the workflow is breaking. We’ll show you where to begin.
Send us a message
Continue on your phoneScan to open a pre-addressed email draft.Email contact@theprimevital.com