Medicare's ACCESS model targets 5-point PHQ-9 and 4-point GAD-7 drops
ACCESS is voluntary: a practice applies, and its patients sign up. Score your patients at every visit now to see how many would reach each target.
Co-founder, JotPsych
You're deciding whether your practice should apply to ACCESS, short for Advancing Chronic Care with Effective, Scalable Solutions. Your charts hold each patient's Patient Health Questionnaire-9 (PHQ-9) or Generalized Anxiety Disorder-7 (GAD-7) score from intake. Later scores are rare.
Medicare's payment rules for ACCESS set a 5-point PHQ-9 target and a 4-point GAD-7 target, each counted from the patient's own baseline score. A patient who starts far above 10 has the same target as one who starts at 10.
ACCESS bases each target on a baseline your practice sends after sign-up. Your intake scores won't be that baseline. Neither will a score taken before you apply. Take a reference score now for your own count.
How ACCESS works
The Centers for Medicare & Medicaid Services (CMS) started ACCESS on July 5, 2026, and the model runs 10 years in Original Medicare. Your practice has to be enrolled in Medicare Part B to apply. CMS reviews applications on a rolling basis. Patients then sign up with your practice, on their own or on a referral.
Each patient's 12-month care period starts at sign-up. Within 60 days, your practice sends CMS a baseline PHQ-9 or GAD-7 score taken no more than 15 days earlier. Your practice then sends a score every quarter.
| Measure | Baseline score | Target |
|---|---|---|
| PHQ-9 | 10 or more | Drop 5 points |
| PHQ-9 | Under 10 | Stay under 10 |
| GAD-7 | 10 or more | Drop 4 points |
| GAD-7 | Under 10 | Stay under 10 |
CMS lists these targets in its ACCESS payment rules. A patient counts toward full payment only when every required score meets its target.
On the depression and anxiety track, Medicare allows your practice up to $180 a year per patient, and the CMS payment rules hold back half until the care period ends. Full payment needs at least half of your patients on target. Your patients who stop coming count as misses.
Your practice also sends one more measure at the end: the Patient Global Impression of Change, a one-question rating by the patient of the change since treatment began.
The payment rules space quarterly scores 70 to 110 days apart and count a missing end score as a miss. Only the second record shows the drop from the baseline.
What to do before you apply
- Send your patients the PHQ-9, or the GAD-7 for anxiety, before every visit.
- Count the patients with a reference score of 10 or more who have dropped 5 points on the PHQ-9 or 4 on the GAD-7.
- Check that each patient with a reference score under 10 stays under 10.
Send a PHQ-9 or GAD-7 by text from JotPsych, and each score lands in the patient's chart with its date.
See JotPsych- Centers for Medicare & Medicaid Services, ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model, from July 5, 2026.
- Centers for Medicare & Medicaid Services, ACCESS Model payment amounts and performance targets, effective July 5, 2026, to December 31, 2027.