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For providers

Put a number on your coordination time

Mallowa™ captures the care-coordination work you already do and assembles billing candidates you review before submitting. Estimate what your caseload could support under the 2026 Medicare Physician Fee Schedule — an estimate, not a promise of coverage or payment.

Estimate it

How much could your caseload’s coordination time support?

Programs you’d run:

Estimated annual billing-candidate value (10 patients priced at Medicare rates):$14,830
The link encodes your assumptions only — never any patient information.

Honest math: estimates use national non-facility Medicare CY2026 rates and base codes only (no add-on stacking). Medicaid rates are set by each state and are not modeled here, so a Medicaid-heavy caseload will differ. Commercial rates vary and are not estimated. Rates are national and unadjusted — your MAC locality moves them in both directions. Patients typically owe ~20% coinsurance. Nothing here is billable until the program’s time threshold, consent, enrollment and attribution rules are met and the payer accepts the claim. Always verify codes and rates with each payer — this is an estimate, not billing advice.

Which 2026 programs pay for care coordination?

ProgramBase codePer patient / monthBasis of estimate
Chronic Care Management99490$66.13Base 20-minute month per enrolled patient (99490 only — add-ons excluded)
Principal Care Management99426$67.80Base 30-minute clinical-staff month (99426)
Behavioral Health Integration99484$57.45Base 20-minute month; psychologists/LCSWs/MHCs/LMFTs bill G0323
Advanced Primary Care ManagementG0557$53.78Level 2 monthly bundle (2+ chronic conditions, G0557)
Community Health IntegrationG0019$86.17Base 60-minute auxiliary-personnel month (G0019)
Principal Illness NavigationG0023$87.18Base 60-minute navigator month (G0023)

How does Mallowa turn that time into billing candidates?

Log coordination work as it happens; Mallowa rolls it up against the 2026 thresholds, applies the consent and enrollment rules, and produces a branded superbill worksheet with your fee schedule’s dollars — print or CSV — for you to review before it goes anywhere. Mallowa does not submit claims and is not a clearinghouse: your billing workflow submits the claim, and each payer decides coverage and payment.

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