How Remote Monitoring May Fit Into ACCESS
CMS's description of ACCESS technology-supported care explicitly includes "use or monitoring of Food and Drug Administration (FDA)-authorized devices, including devices or software, or devices that are subject to FDA enforcement discretion." A participating ACCESS organization may use connected devices and patient-generated data as one component of the broader chronic-care activity tied to its Outcome-Aligned Payment.
The Difference Between the ACCESS Payment Model and RPM Billing
RPM is billed under specific CPT codes (99453/99454/99457/99458) tied to device setup, 16-day data transmission, and monitoring time, and can be billed by any qualifying practice furnishing that monitoring. ACCESS is a separate, broader outcome-based payment to a participating organization, tied to achieving measurable health outcomes across its technology-supported care as a whole — not to specific monitoring minutes or data-transmission days. A practice should not assume ACCESS participation changes how RPM itself is billed, or that RPM billing alone satisfies ACCESS's outcome requirements.
Connected Devices
CMS gives wearable devices that "continuously monitor sleep, heart rate, movement, blood sugar and other functions" as an example of the kind of technology ACCESS organizations may use — consistent with, but not identical to, devices used for separately-billed RPM.
Patient-Generated Data
Data from connected devices or patient-reported outcome measures can inform whether a patient is meeting the outcome targets tied to ACCESS's Outcome-Aligned Payments (e.g., biomarkers like blood pressure or HbA1c, or validated PROMs of pain, mood, and function).
Alerts
CMS's published ACCESS materials describe care escalation as one of three key update points shared with primary care (alongside initiation and completion) when a patient's clinical needs change — the specific alerting mechanics are determined by each participating organization's own technology, not standardized by CMS in the pages reviewed for this guide.
Outcomes
Under ACCESS, payment is tied to the share of patients meeting defined outcome targets — a fundamentally different accountability structure than RPM's per-code billing for monitoring activity performed.