| CCM | ACCESS Model | |
|---|---|---|
| Program type | Standard Physician Fee Schedule billing codes | 10-year CMS Innovation Center model, application required |
| Payment structure | Time-based, per code, each month | Outcome-Aligned Payments tied to measurable results |
| Patient focus | Any patient with 2+ qualifying chronic conditions | Specific clinical tracks (eCKM, CKM, MSK, BH, plus 2027 additions) |
| Technology use | Certified EHR for structured information | Explicit technology-supported care: telehealth, wearables, FDA-authorized devices |
| Care-management model | Delivered by the billing practice's own staff | Delivered by a separate participating organization |
| Outcome focus | Not tied to a measured health outcome | Full payment tied to achieving defined outcome targets |
| Billing approach | 99490/99439/99487/99489 (or 99491/99437) monthly | OAP to the organization; G0676/G0677/G0678 co-management payment to the PCP |
| Practice workflow | Self-contained within one practice | Referral relationship between PCP and participating organization |
| Documentation | Monthly time and activity logs | Review-and-action documentation for co-management; outcome data for the organization |
| Care-team model | One practice's clinical staff | Two parties: ACCESS organization plus the referring PCP |
| Use case | Direct in-house time-based billing | Referral into a specialized outcome-based program, with PCP coordination pay |
Program Type
CCM is a standard Physician Fee Schedule billing code family available to any qualifying practice. ACCESS is a time-limited (10-year) CMS Innovation Center model that participating organizations must apply to join.
Who Gets Paid
CCM pays the treating practitioner's own practice for qualifying time. ACCESS pays a separate participating organization for outcome-based chronic care, while the patient's own primary care provider can separately bill a co-management payment for coordinating with that organization.
Payment Structure
CCM pays per code based on monthly clinical-staff or practitioner time thresholds. ACCESS pays recurring Outcome-Aligned Payments tied to the share of a participating organization's patients meeting defined health-outcome targets.
Patient Focus
CCM covers any patient with two or more qualifying chronic conditions. ACCESS is organized around specific clinical tracks (eCKM, CKM, MSK, BH at launch, with more added in 2027) with track-specific outcome measures.
Technology Use
CCM requires certified EHR use for structured health information. ACCESS explicitly incorporates technology-supported care activities — telehealth, wearables, FDA-authorized devices, coaching apps — as part of what participating organizations deliver.
Outcome Focus
CCM does not tie payment to a measured health outcome — it's paid for qualifying time and activity. ACCESS ties full payment to achieving measurable outcomes (biomarkers or patient-reported measures) against a rising yearly threshold.
Billing Approach
CCM is billed monthly by the treating practice under 99490/99439/99487/99489 (or 99491/99437). ACCESS's Outcome-Aligned Payment is billed by the participating organization, while the primary care provider separately bills the co-management payment (G0676/G0677/G0678) up to three times per 12-month care period.
Practice Workflow
CCM is typically run entirely within one practice's own care team. ACCESS introduces a referral relationship: a primary care practice refers patients to a separate participating organization and then reviews that organization's structured updates.
Documentation
CCM requires monthly time and activity documentation. ACCESS's co-management payment requires documenting review of a care update plus a specific coordination action; the participating organization separately documents the outcome measures tied to its own payment.
Care-Team Model
CCM care is generally delivered by the billing practice's own clinical staff. ACCESS explicitly involves two parties: the participating ACCESS organization delivering technology-supported care, and the primary care provider maintaining overall continuity and coordination.
Use Case
CCM fits a practice that wants to bill directly for its own ongoing care-coordination time. ACCESS fits a practice that wants to refer patients into a specialized, technology-enabled program for a specific clinical track while staying involved through the co-management payment.