Navigate Shifting Reimbursement Criteria for Molecular Testing
At TELCOR, we’ve recently identified a notable shift in how molecular claims specifically associated with CPT code 87798, are being processed by...
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On Dec. 4, the Centers for Medicare & Medicaid Services convened a meeting with government and health care leaders to discuss the CMS Innovation Center Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model, meant to modernize the U.S. digital health ecosystem.
Set to begin in July 2026, the ACCESS Model will introduce an outcome-aligned payment option that rewards results rather than required activities. The model is meant to integrate with the broader health care system to refer Medicare beneficiaries to ACCESS participants as an extension of their clinical care. More than 350 technology-enabled care organizations have formally expressed their intentions to apply for participation in the ACCESS Model.
During the meeting, the U.S. Food and Drug Administration also discussed the Technology-Enabled Meaningful Patient Outcomes (TEMPO) pilot, which would function in collaboration with the ACCESS Model for participating manufacturers of certain digital health devices to offer devices for care covered by the ACCESS Model while gathering performance data.
According to CMS, clinical and patient societies, such as the American Medical Association, and payer consortiums AHIP and Blue Cross Blue Shield Association have expressed support for the ACCESS Model.
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