ACCME announces new tiered fee structure for pass through fee

July 02, 2019
Area(s) of Interest: Continuing Medical Education (CME) 

The ACCME is implementing a new, tiered structure for the annual accreditation fee in response to suggestions from the accredited provider community and to better distribute the responsibility for sustaining our system more fairly among accredited programs of different sizes. The following is information provided by ACCME about the changes.

CMA’s accredited providers received individualized information about the tier in which the organization falls via e-mail and letter sent to the provider’s primary contact.


The ACCME recognizes that many state-accredited providers are smaller and have fewer resources than national providers. A tiered fee structure will enable the ACCME to continue to substantially subsidize the state system, continue to charge no fees to Recognized State Medical Society Accreditors, keep fees much lower for state-accredited providers, improve services for you, better help you meet the needs of your learners, and ensure that accredited CME continues to be valued and effective in the rapidly evolving health care environment. 

How It Works

There are four fee tiers, from Tier 1, comprising the smallest programs, to Tier 4, comprising the largest programs. (See table on page 2) Program size is based on the average number of activities or learner interactions, whichever falls into the higher tier, over the past three years. The ACCME used data that providers entered into the Program and Activity Reporting System (PARS) for the 2016–2018 reporting years to assign tiers for the 2020 and 2021 annual accreditation fees.

Tiered Fee Structure for State-Accredited Providers, 2020– 2021
Tier Approx. Centile Average Activities Per Year Average Learner Interactions Per Year State-Accredited Providers:  2020 and 2021 Fee* ACCME-Accredited Providers: 2020 and 2021 Fee*
Tier 1 Lowest half <29 <2,685 $750 $5,900
Tier 2 51 - 75% 29 - 79 2,685 - 8,519 $1,000 $6,500
Tier 3 76 - 95% 80 - 260 8,520 - 43,687 $1,500 $7,500
Tier 4 Largest 5% > 260 > 43,687 $3,000 $10,000

*ACCME may change the fees after 2021.

The fees will be in place for two years; the ACCME may change the fees after that time. If your organization was newly accredited, the ACCME used data from the most current year to determine your tier; the ACCME may change the 2021 fee for those organizations based on 2019 data reported in PARS.  

Why ACCME Changed the Fee Structure

The ACCME is responsible for maintaining a national system of balanced, evidence-based continuing education that effectively meets the needs of clinicians and the expectations of the public, and that flexibly adapts to the evolving health care environment. To do so, the ACCME must make substantial investments in its processes, data systems, and services. The ACCME relies on annual accreditation fees as its major source (69 percent) of yearly revenue. The ACCME operates with a closely balanced, conservative budget, using its revenues to achieve its strategic goals. After careful deliberations and analysis of its data, the ACCME executive leadership and Board of Directors determined that implementing a tiered accreditation fee structure is necessary to allow the ACCME to continue to fulfill its strategic responsibilities.

The ACCME heard from providers that charging the same annual accreditation fee to all organizations regardless of CME program size is becoming increasingly burdensome for smaller, under-resourced providers. Mergers and acquisitions, particularly in the hospital and health system sector, mean that large organizations consolidate the accreditation of multiple smaller CME programs under one umbrella. This trend is reducing the number of providers and driving greater size disparity among providers.

The ACCME believes the diversity of our provider community is one of our greatest strengths and is committed to supporting the success of all our providers. This tiered structure will be fairer and more sustainable, allowing the ACCME to keep fee increases modest for smaller providers (with no increase for the smallest providers in the next two years), while providers with the largest programs will contribute more.

How ACCME Supports You

The revenue from your annual accreditation fee supports the goals described in the ACCME’s strategic plan, Transforming Education to Improve Health, including continued enhancements to data systems and services. The ACCME is working hard to support California Medical Association and you through the following initiatives.

Services specific to Recognized State Medical Society Accreditors:

  • Ongoing education and feedback in support of equivalency between the state and national accreditation systems
  • Technical solutions for reporting decisions and compliance findings for state-accredited providers
  • Support for the ACCME Academy, a learning management system for Recognized Accreditor staff and volunteers

Continued enhancements to ACCME services and data systems for the accredited CME community, including:

  • Advocacy for the value of accredited CME to health leaders, government agencies, and other stakeholders to encourage resourcing and recognition of CME programs
  • Protecting the reputation of accredited CME through interactions with the government and other regulatory authorities, the media, and national forums
  • Collaborations with certifying and licensing boards to streamline processes for CME providers and reduce burdens for clinicians
  • Safeguarding the integrity of accredited CME, including review of the ACCME Standards for Commercial Support: Standards to Ensure Independence in CME Activities℠ to identify potential revisions that will assure their continued relevance and effectiveness
  • Continuous improvement of the online accreditation system
  • The Program and Activity Reporting System expanded to enable providers to enter more learner data, identify activity content, and choose to display any of their activities in CME Finder, in addition to CME that counts for Maintenance of Certification, the FDA Opioid Analgesics Risk Evaluation and Mitigation Strategy, and the Merit-Based Incentive Payment System
  • A new process and system to handle complaints and inquiries
  • Evolved approaches for quality control to ensure consistent quality in accredited CME

You can find more information about these initiatives in the recent report, Advancing CME to Optimize Care, available on the ACCME website.

If you have questions, the CMA CME program can be contacted at cme@cmadocs.org. ACCME can be contacted at info@accme.org.


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