ACCESS Model HCPCS G-Code Allowed Amounts: July 2026
Outcome-Aligned Payment (OAP) HCPCS G-Codes
Pricing information is now available for new Healthcare Common Procedure Coding System (HCPCS) codes payable under Medicare when furnished for the Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model.
The ACCESS Model is a 10-year voluntary Innovation Center model that tests whether an alternative payment methodology, Outcome-Aligned Payments (OAPs), for technology-enabled chronic care reduces expenditures while enhancing quality of care for Medicare beneficiaries. It is scheduled for implementation on July 1, 2026. Beginning in 2027, these codes will be listed on a new CMMI payment file. All ACCESS model HCPCS codes can be billed with telehealth place of service (POS) codes 02 and 10.
| HCPCS | Short Descriptor | Long Descriptor | Monthly Allowed Amount |
|---|---|---|---|
| G0669 | Eckm oap-initial period | Outcome-Aligned Payment (OAP) for technology-enabled chronic care management of early cardio-kidney-metabolic (eCKM) conditions (hypertension, or two or more of: dyslipidemia, obesity/overweight with central obesity marker, prediabetes); initial 12-month period; per month | $30.00 |
| G0670 | Eckm oap-follow-on period(s) | Outcome-Aligned Payment (OAP) for technology-enabled chronic care management of early cardio-kidney-metabolic (eCKM) conditions (hypertension, or two or more of: dyslipidemia, obesity/overweight with central obesity marker, prediabetes); follow-on 12-month period; per month | $15.00 |
| G0671 | Ckm oap-initial period | Outcome-Aligned Payment (OAP) for technology-enabled chronic care management of cardio-kidney-metabolic (CKM) conditions (one or more of: diabetes mellitus, chronic kidney disease Stage 3a or 3b, atherosclerotic cardiovascular disease); initial 12-month period; per month | $35.00 |
| G0672 | Ckm oap-follow-on period(s) | Outcome-Aligned Payment (OAP) for technology-enabled chronic care management of cardio-kidney-metabolic (CKM) conditions (one or more of: diabetes mellitus, chronic kidney disease Stage 3a or 3b, atherosclerotic cardiovascular disease); follow-on 12-month period; per month | $17.50 |
| G0673 | Msk oap-initial period | Outcome-Aligned Payment (OAP) for technology-enabled chronic care management of musculoskeletal (MSK) conditions (chronic musculoskeletal pain); initial 12-month treatment period; per month | $15.00 |
| G0674 | Bh oap-initial period | Outcome-Aligned Payment (OAP) for technology-enabled chronic care management of behavioral health (BH) conditions (one or more of: depression, anxiety); initial 12-month period; per month | $15.00 |
| G0675 | Bh oap-follow-on period(s) | Outcome-Aligned Payment (OAP) for technology-enabled chronic care management of behavioral health (BH) conditions (one or more of: depression, anxiety); follow-on 12-month period; per month | $7.50 |
ACCESS HCPCS codes and modifier descriptions
HCPCS Codes
| HCPCS | Short Descriptor | Long Descriptor | Allowed Amount |
|---|---|---|---|
| G0676 | Std co-mgmt-eckm, ckm | Standard Co-Management service payment for documented review of clinical updates from ACCESS Participant managing cardio-kidney-metabolic conditions (early cardio-kidney-metabolic [eCKM] or cardio-kidney-metabolic [CKM]); per review | $30.00 |
| G0677 | Std co-mgmt-msk | Standard Co-Management service payment for documented review of clinical updates from ACCESS Participant managing musculoskeletal (MSK) conditions; per review | $30.00 |
| G0678 | Std co-mgmt-bh | Standard Co-Management service payment for documented review of clinical updates from ACCESS Participant managing behavioral health (BH) conditions (depression, anxiety); per review | $30.00 |
Modifier Descriptions
| Modifier | Short Descriptor | Long Descriptor | Allowed Amount |
|---|---|---|---|
| AC | Co-mgmt mod – onboarding | Initial onboarding support payment for access beneficiary enrollment, device/app setup, and care coordination activities; first month only; once per beneficiary per track. | $10.00 |
ACCESS HCPCS Codes That Include GAF
Florida
| HCPCS Code | Carrier | Locality | Modifier | Price |
|---|---|---|---|---|
| G0678 | 09102 | 03 | $31.17 | |
| G0678 | 09102 | 03 | AC | $41.17 |
| G0678 | 09102 | 04 | $32.43 | |
| G0678 | 09102 | 04 | AC | $42.43 |
| G0678 | 09102 | 99 | $30.00 | |
| G0678 | 09102 | 99 | AC | $40.00 |
Puerto Rico / U.S. Virgin Islands
| HCPCS Code | Carrier | Locality | Modifier | Price |
|---|---|---|---|---|
| G0678 | 09202 | 20 | $30.12 | |
| G0678 | 09202 | 20 | AC | $40.12 |
| G0678 | 09202 | 50 | $30.12 | |
| G0678 | 09202 | 50 | AC | $40.12 |
| G0678 | 09202 | 20 | $30.12 | |
| G0678 | 09202 | 20 | AC | $40.12 |