Notes & Feedback — ACCESS Program
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Government Program
Medicare Fee-for-Service Chronic Disease Management
34.8 million Medicare FFS beneficiaries. 10 chronic conditions. $15-22 PMPM per enrolled patient. This is the government-funded revenue engine.
Organization submits intake form with physician count, NPI, Medicare FFS patients, chronic condition volumes.
20-30% of patients qualify based on 10 chronic conditions. Enrolled via doctor office activation (QR codes, staff).
$15-22 PMPM flows from CMS. Practice keeps 70% (plus quality bonuses + app revenue share). RevDoc earns a 30% platform fee. RPM/CCM billing stacks on top separately.
| Condition | ICD-10 Codes | Prevalence |
|---|---|---|
| Hypertension | I10-I16 | ~45% of Medicare |
| Diabetes | E8-E13 | ~27% |
| Dyslipidemia | E78.x | ~44% |
| Obesity | E66.x | ~40% |
| Prediabetes | R73.x | ~33% |
| CKD (non-ESRD) | N18.x | ~15% |
| Cardiovascular | I25.x | ~12% |
| Chronic Pain | G89, M54, M25 | ~20% |
| Depression | F32-F34 | ~17% |
| Anxiety | F40-F43 | ~15% |
Reason: Duplicative of ACCESS coordination
Important: RPM/CCM billing is SEPARATE from ACCESS — it stacks on top as additional back-office revenue. The crosswalk above applies to ACCESS-funded coordination only. RPM codes can be billed independently when properly documented.
Qualifying Patients
125
Monthly Revenue
$2,375
Annual Revenue
$28,500
Practice Net (70%)
$1,663/mo
RevDoc Platform Fee (30%)
$713/mo
+ RPM/CCM Back Office
Stacks on top
ACCESS is EPC/CM only. For full product flexibility (DPC, concierge, cash-pay), target the private employer market where there are zero billing restrictions.