What Is the CMS ACCESS Model?
ACCESS stands for "Advancing Chronic Care with Effective, Scalable Solutions." It's a CMS Innovation Center model that tests an outcome-aligned payment approach in Original Medicare to expand access to technology-supported care options for preventing and managing chronic disease — addressing what CMS describes as limited access to this kind of care today because of Medicare payment barriers.
When Did ACCESS Start?
ACCESS started July 5, 2026, and is designed to run for 10 years, with rolling participant start dates. A second set of clinical tracks is scheduled to begin April 1, 2027.
What Conditions Are Included?
ACCESS launched with four clinical tracks: early cardio-kidney-metabolic (eCKM) — hypertension, dyslipidemia, obesity/overweight with a central obesity marker, and prediabetes; cardio-kidney-metabolic (CKM) — diabetes, chronic kidney disease (stages 3a/3b), and atherosclerotic cardiovascular disease; musculoskeletal (MSK) — chronic musculoskeletal pain; and behavioral health (BH) — depression and anxiety. Starting April 1, 2027, CMS plans to add heart failure, COPD, substance use disorder, tobacco cessation, and a chronic MSK pain follow-on track.
Who Can Participate?
Participating organizations must be enrolled in Medicare Part B (excluding durable medical equipment/prosthetics/orthotics/supplies and laboratory suppliers) and must designate a Medicare-enrolled physician Medical Director responsible for clinical oversight and compliance. More than 160 organizations have been accepted as ACCESS participants to date. Primary care providers and referring clinicians do not need to enroll in ACCESS themselves to refer patients or bill the co-management payment described below.
Technology-Supported Care
CMS describes ACCESS care organizations as offering integrated, technology-supported care that may include clinician consultations, lifestyle and behavioral support (nutrition, exercise, smoking cessation), therapy and counseling, patient education and care coordination, medication management, ordering and interpreting diagnostic tests, and use or monitoring of FDA-authorized devices or software. Care can be delivered in person, virtually, asynchronously, or through other technology-enabled methods — including telehealth software, wearable devices, and coaching apps.
Outcome-Aligned Payment
ACCESS tests Outcome-Aligned Payments (OAPs): recurring payments to participating organizations for managing a patient's qualifying condition, with the full payment tied to achieving measurable health outcomes (such as improvement or control in blood pressure, HbA1c, lipids, weight, or validated patient-reported outcome measures of pain, mood, and function). Payment is based on the share of an organization's patients who meet their defined outcome targets, compared against a minimum threshold that increases each participation year. Most tracks include an initial year of care followed by an optional continuation period at a reduced rate.
Primary Care Provider Role
Primary care providers can refer patients to participating ACCESS organizations and receive structured electronic updates on patient progress — without needing to enroll in ACCESS themselves. CMS is explicit that "ACCESS health care providers provide supplemental chronic care support; they do not replace" the primary care provider's role, and the patient can continue seeing their PCP and any other Medicare provider as usual.
Referring Clinician Role
CMS treats referring clinicians similarly to primary care providers in this model: they can refer patients, receive the same structured care updates, and bill the same co-management payment described below.
Co-Management Opportunities
Primary care providers and referring clinicians may bill a new Co-Management Payment (CMP) for reviewing a documented ACCESS care update and performing at least one related coordination activity, such as a medication adjustment, problem-list update, or referral. The CMP uses new HCPCS codes G0676 (eCKM/CKM track), G0677 (MSK track), and G0678 (BH track), each paid at $30 per service (subject to geographic adjustment and sequestration), with a one-time $10 add-on (Modifier AC) available for patient-onboarding assistance. It can be billed up to three times per 12-month care period, per patient, per ACCESS track.
How ACCESS Differs From CCM
This is ChronicSync's own comparison, not a claim CMS makes directly. CCM is billed by the treating practitioner's own practice based on monthly clinical-staff or practitioner time. ACCESS pays a separate participating organization for outcome-based chronic care, while the patient's own primary care provider continues billing separately (including the new co-management payment) rather than performing the ACCESS-funded activity itself. See our ACCESS vs CCM comparison for a fuller breakdown.
How ACCESS Differs From RPM
Remote Patient Monitoring (RPM) is billed under specific CPT codes (99453/99454/99457/99458) tied to device setup, data transmission, and monitoring time, by whichever practice furnishes that monitoring. ACCESS is a broader outcome-based payment to a participating organization that may use FDA-authorized devices as one component of its technology-supported care — it is not itself an RPM billing code, and the two shouldn't be conflated. See our ACCESS and Remote Patient Monitoring guide.
Technology Requirements
ACCESS organizations must share structured care updates with primary care/referring clinicians through HIPAA-compliant secure electronic methods (Direct Secure Messaging, a network-supported push mechanism, or HIPAA-compliant eFax). By July 2027, all participants must connect to a CMS Aligned Network or Health Information Exchange, enabling clinicians to query structured patient data such as biomarkers, patient-reported outcome measures, and medications through their existing systems.
Implementation Considerations
For a primary care practice, the main implementation questions are: which patients to refer, how to receive and act on ACCESS care updates, and how to bill the co-management payment correctly. See our ACCESS Model for Primary Care Practices guide for a practical breakdown.