CMS Sets $90-$420 Per-Patient Payments for Chronic Care Tech

CMS has set a payment range for technology-supported chronic care under a model called ACCESS (Advancing Chronic Care with Effective, Scalable Solutions), which went fully into effect in July 2026, according to HFMA, a healthcare finance trade publication. Companies that qualify can receive $90 to $420 per Medicare beneficiary per year based on whether they meet specified outcome targets, HFMA reported.

What ACCESS requires of participating companies

HFMA reported that ACCESS targets organizations providing technology-supported care to Original Medicare beneficiaries with chronic conditions, including hypertension, prediabetes or diabetes, obesity, chronic kidney disease, atherosclerotic heart disease, chronic musculoskeletal pain, and depression or anxiety. Many participating organizations resemble digital health or device companies rather than traditional provider groups, and they often reach patients through telehealth or remote monitoring, according to HFMA.

To collect payment, companies must first enroll as Medicare Part B providers, HFMA reported. They must also exchange data with patients and other providers through a CMS application programming interface into what CMS calls Aligned Networks, health information networks and platforms that meet a CMS interoperability framework, according to HFMA. At the time of HFMA's reporting, more than 700 organizations and individuals had pledged support for a related CMS initiative called the Health Technology Ecosystem, and more than 150 had enrolled in ACCESS. HFMA noted that most participants so far are technology companies, with relatively few traditional providers signed on.

A broader CMS technology push, and separate industry deals

ACCESS sits inside a wider CMS effort launched in 2025 aimed at expanding use of health technology, HFMA reported. As part of that effort, CMS published a library of CMS-approved digital applications for Medicare patients and contracted with identity-verification company CLEAR to build a system intended to confirm patient identities, according to HFMA.

Elsewhere in health technology, HealthTech Magazine reported in January 2026 that healthcare IT leaders it interviewed described moving from evaluating generative AI in 2023 to running multiple AI pilots by the end of 2025, with reported use cases including appointment-scheduling automation, patient outreach, and prior-authorization support. In venture funding, Fierce Healthcare reported on Sept. 8, 2026, that Forus, a company that automates prescription-related administrative work such as prior authorizations, raised a $150 million Series C round at a $3 billion valuation. And Fierce Biotech reported on Aug. 10, 2026, that Novo Nordisk and Amazon Web Services signed a partnership involving AI tools for drug discovery and a planned innovation hub in London.

MarketScale analysis

For vendors and health systems, the $90-to-$420 annual payment ceiling under ACCESS functions as a budget constraint: a service that requires substantial manual reconciliation or duplicate documentation may be difficult to sustain within that payment range once integration and reporting costs are included. Organizations considering ACCESS participation may want to confirm Part B enrollment requirements and clarify which data-reporting tasks fall to clinicians versus vendors before committing resources.