Same-day access to behavioral health services is a critical feature of integrated primary care. Despite the benefits of same-day access, implementing and sustaining this key feature has been a challenge for multiple health care settings. Further, there is relatively little practical guidance on how to implement this practice management feature. Diverse program design solutions for same-day access are implemented in clinics across the Veterans Health Administration. The authors identified innovative approaches, developed in local facilities, with demonstrated success in same-day access that can be implemented in any setting. The purpose of this article is to describe five approaches for providing same-day access within integrated care. The authors discuss key considerations (staffing, space, program maturity), potential challenges and facilitators, and provide practical recommendations for implementation.