This page is part of the ACCESS Model IG v0.9.8 DRAFT (v0.9.8: Releases Draft) based on FHIR (HL7® FHIR® Standard) R4. No current official version has been published yet. For a full list of available versions, see the Directory of published versions

Change Log

This page documents the changes between versions of the CMS ACCESS Model API Implementation Guide.

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Version 0.9.8 - DRAFT

Release Date: May 18, 2026

Major Changes

Addressed feedback from first external testing window

• Fixed questionnaire responses that are uncoded so that they have both the text (display) and numerical values for scoring
  • Now use valueCoding with decimal extension instead of valueString
  • More consistent with the coded questionnaire responses

• Added example questionnaires to provide further guidance on how to package questionnaire response data

• Added more documentation for each of the ACCESS Model API operations to make them easier to implement

• Added new result codes for the $check-eligibility operation
  • not-eligible-clinical-exclusion - The patient has a clinical exclusion that prevents them from receiving services under the ACCESS Model.
  • not-eligible-mismatch - The patient information provided does not match the patient information on record.
• Added new result codes for the $align operation
  • not-aligned-clinical-exclusion - The patient has a clinical exclusion that prevents them from receiving services under the ACCESS Model.
  • not-aligned-mismatch - The patient information provided does not match the patient information on record.
  • not-aligned-no-switch-attestation - Participant switch request did not include switch consent attestation.
• Fixed LOINC code usage bug for lipids
  • All 57698-3 LOINC codes were replaced by 18262-6 LOINC codes
• Replaced itemWeight references with ordinalValue
  • Some servers do not support itemWeight
• Added invariant to dataBundle
  • Items reference in the ACCESSDataReportingComposition must be in the ACCESSDataReportingBundle
• Updated Getting Started section of the IG home page

Changed Structured Data Capture IG dependency

• Changed from using version 4.0.0 (STU4) to version 3.0.0 (STU3)
• Better aligns with USCoreQuestionnaireResponse version 6.1.0

More blood pressure examples

• dataBundle examples now include three individual blood pressure observations

Technical Updates

• Version bump from 0.9.6 to 0.9.8

Version 0.9.6 - DRAFT

Release Date: April 24, 2026

Major Changes

ACCESSDataReportingComposition tweaks

• Added artifacts for the Data Reporting API

Replaced average blood pressure with individual blood pressure observations

• Removed ACCESSAverageBloodPressure profile from the IG
• Updated ACCESSDataReportingComposition to reference USCoreBloodPressure instead of ACCESSAverageBloodPressure and LOINC codes for individual blood pressure observations
• Updated blood pressure examples to use USCoreBloodPressure
• Updated documentation to reflect the change

Added cannot-unalign-during-lock-in to ACCESSUnalignmentResultCS

• Patient cannot be unaligned during the 90-day lock-in period

Added required entityId query parameter to ACCESS Capability statements

• entityId required for $check-eligibility, $align, $unalign, $report-data operations

Track-based condition profiles have a fixed condition category of problem-list-item

• Condition category update made to ACCESSeCKMCondition, ACCESSCKMCondition, ACCESSMSKCondition, and ACCESSBHCondition

Changed ACCESS ID format

• New ACCESS ID format for participants now takes the form of ACCES##### (ACCES followed by 5 digits)
• Replaces previous format of ACCESS#### (ACCESS followed by 4 digits)

Changed IG path from cms.fhir.us.access to cms.fhir.us.cmmi-access-model

• More specific to the division in CMS.

Lock-in Duration

• References to 3-months changed to 90 days

Technical Updates

• Version bump from 0.9.1 to 0.9.6