Blog

2026 Initiatives from CMS: ACCESS, Care Management Changes, and How They Impact Your Practice

Care management has proven to be a major focus for CMS in 2026. On July 5, 2026, the ACCESS model officially launched, emphasizing the use of technology-supported, at-home devices to help Medicare patients manage chronic conditions.

During the same year, the Chronic Care Management (CCM) program increased its reimbursements for the first time since 2022. Throughout 2026, the average national reimbursement for CCM has been $66.13 for code 99490, a 9% increase over 2025.

2026 also brought new add-on codes for Advanced Primary Care Management (APCM) and new codes for Remote Patient Monitoring (RPM), signaling CMS’s ongoing support for care management programs. 

We’ll tackle what you need to know about ACCESS now that the program has begun, as well as how other remote care models have shifted and which ongoing programs are most likely to improve Medicare patient outcomes. 

The ACCESS Model from CMS

The ACCESS Model was officially announced on December 1, 2025 and launched on July 5, 2026. ACCESS stands for Advancing Chronic Care with Effective, Scalable Solutions. CMS describes it on their website as “technology-supported care” to help people with Medicare prevent and manage chronic conditions in the following categories:

• Early Cardio-Kidney-Metabolic (hypertension, hyperlipidemia, prediabetes) 
• Cardio-Kidney-Metabolic (diabetes, chronic kidney disease, heart disease) 
• Musculoskeletal (chronic musculoskeletal pain) 
• Behavioral Health (depression and anxiety)
  

Participation is optional, and the program is planned to last for 10 years. More than 150 organizations, among them technology companies and medical practices, have signed up to participate at launch. 

How Is ACCESS Different from Existing Care Management Programs? 

ACCESS is different from existing care management programs principally in its approach to outcome-based payments and its emphasis on technology. 

Advanced Primary Care Management and Chronic Care Management encourage multiple modes of communication with patients, and APCM requires digital options to be available. However, technology is not the primary focus of APCM or CCM—connecting with patients and clinical services are. If a patient prefers to use low-technology options, such as phone calls or text, they are welcome to do so.

Remote Patient Monitoring requires the use of a device but is specific about which clinical devices are allowed. To bill for RPM, you must use medical devices like glucometers or blood pressure cuffs. For example, an app without an attached device or a smart watch would not count as an allowed device under RPM.

ACCESS is more liberal in its definition of what technology can be used. As long as patients’ outcomes improve, forms of technology such as apps or fitness trackers are allowed, even if they aren’t classified as medical devices.

Outcome-Based Payments

Chronic Care Management, Advanced Primary Care Management, and Remote Patient Monitoring all ask providers to consider quality measures, and APCM requires participation in defined quality programs. However, CCM, APCM and RPM also offer Fee-for-Service payments each month for fulfilling the program’s requirements. 

ACCESS, on the other hand, will use Outcome-Aligned Payments (OAPs). Participating organizations will receive partial recurring payments each month for managing patients’ qualifying conditions. Full payment is withheld until providers can demonstrate that they’ve achieved measurable health outcomes at the end of the year.

CMS determines payment based on the percentage of patients who meet their defined outcome goals, with the threshold increasing for each year of participation. 

What Are the Reimbursements for CMS ACCESS? 

While many healthcare organizations were excited about the technology emphasis and relatively low provider workload for ACCESS, the reimbursements for ACCESS are notably lower than those for other care management programs.

The July 2026–July 2027 national reimbursements are: 

• Early Cardio-Kidney-Metabolic: $360 per patient, per year
• Cardio-Kidney-Metabolic: $420 per patient, per year
• Muscoskeletal  = $180 per patient, per year
• Behavioral Health = $180 per patient, per year

When broken down by month, this comes out to $15–35 per patient, per month. This is substantially lower than the national 2026 averages for CCM ($66.13 per patient, per month), APCM Levels 2 and 3 ($53.78 and $117.24 per patient, per month, respectively) and RPM ($52.11 per patient, per month.)*

In fact, the only care management program that pays as low as ACCESS is APCM Level 1 ($16.37 per patient, per month), which is designed specifically for patients with one or no chronic conditions and low support needs. ACCESS could serve patients with only one chronic condition, but could also serve patients with multiple chronic conditions.

This is concerning for providers. If patients need substantial support to manage multiple conditions, $15-35 per month will not cover the cost of caring for them—and some of that reimbursement may even be lost based on outcomes, dropping reimbursements as low $8-$9.

For practices who want to provide clinical services or have a partner who can, CMS has increased rates for CCM, RPM and APCM and added new codes for RPM and APCM. 

*Results may vary by provider. 

Reimbursement Rate Increases for CCM

In 2026, providers who participate in an Advanced Payment Model, such as an ACO, will receive a reimbursement increase of 3.77% for care management services, including RPM, APCM and CCM. Non-APM providers will see a 3.26% overall increase.

When combined with the increases included in House Bill H.R. 1 (2025-2026), the total increase for CCM reimbursements is 9.32% nationally. This brings CCM reimbursements up to a national average of $66.13 per patient, per month, compared to last year’s $60.49 per patient, per month.

Practices have already seen the benefits of this increase. With revenue that better matches the workload required, they are able to offer preventive, remote care to more patients. For practices who don’t feel ACCESS is a good fit, Chronic Care Management continues to be one of the most consistent, highest-reimbursing care management programs.

These increases also apply to APCM and RPM. However, in addition to rate increases, APCM and RPM are using new codes in 2026. 

New Reimbursement Codes for RPM

In 2026, practices have benefitted from a new RPM code, 99445, which applies to 2-15 days of transmitted data per month. The existing code, 99454, was adjusted to apply to 16-30 days of transmitted data. This was exciting news for many practices offering or considering RPM.

Previously, a patient who submitted 15 days of data each month would lead to no reimbursement for the practice, even when clinical staff viewed the data and incorporated it into the patient’s care. Now, as long as patients submit at least two days of data, the practice receives reimbursement for using those data insights to improve patient outcomes.

Codes 99445 and 99454 both reimburse at a national average rate of $52.11 in 2026. The ability to receive reimbursement for either of these two codes has led to higher reimbursements for many practices. 

New add-on codes for APCM (G0568, G0569, G0570)

In addition to raising reimbursements for APCM by 8-10%, CMS also added two new add-on codes for General Behavioral Health Integration (BHI) and the Collaborative Care Model (CoCM).

These codes allow practices to bill for APCM and BHI/CoCM for the same patient in the same month. The add-on codes are:

G0568 (CoCM add-on, initial month): $161 per patient, per month
G0569 (CoCM add-on, following months): $146 per patient, per month
G0570 (BHI add-on): $58 per patient, per month

G0568 and G0569 have high reimbursements because they require that the patient’s primary provider collaborate with a psychiatrist to provide care. G0570 only requires that clinical staff and community resources provide this care, bringing its reimbursement more in line with CCM, RPM or APCM Level 2.

The prospect of adding G0568 and G0569 is overwhelming for health systems or practices without a large, well-established psychiatric arm. G0570 does not require the presence of a psychiatrist but does require dedicated care for behavioral health conditions on top of chronic conditions, which can also add a heavy workload for many practices.

Even for practices who have not adopted the add-on codes, however, APCM reimbursements can prove invaluable. The rates for APCM Level 2, for patients with two or more chronic conditions, rose to $53.78 and the rate for Level 3, Qualified Medicare Beneficiaries with two or more chronic conditions, rose to $117.24. 

While Level 1 reimbursements are lower, they also rose from $15.20 to $16.37. Together, all of these reimbursements lead to more revenue for practices who are offering preventive, proactive care to their patients. 

ACCESS, New Reimbursements, and The Impact on Your Practice

With the launch in July 2026, healthcare practices who have chosen to participate in ACCESS will find out how effective the program is for their patients, how much adoption it sees, and how it will impact their patient outcomes and revenue. 

For those organizations concerned about ACCESS’s lower reimbursements and decreased emphasis on clinical time, Chronic Care Management, Advanced Primary Care Management and Remote Patient Monitoring continue to receive support from CMS. All three have increased reimbursements in 2026, and APCM and RPM have new codes as well.

If your practice is choosing between ACCESS or a more clinically involved care management program, ChartSpan can help you decide with a detailed breakdown of what it takes to launch care management at scale. Want to participate in a more personalized conversation? Schedule a consultation with one of our experts.