GroundRules
42 CFR 512.380: PPA Amounts and schedules.
Where this section sits in the code
- Title 42—Public Health
- CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES
- SUBCHAPTER H—HEALTH CARE INFRASTRUCTURE AND MODEL PROGRAMS
- PART 512—STANDARD PROVISIONS FOR MANDATORY INNOVATION CENTER MODELS AND SPECIFIC PROVISIONS FOR CERTAIN MODELS
- Subpart C—ESRD Treatment Choices Model
CMS adjusts the payments described in § 512.375 based on the ETC Participant's MPS calculated as described in § 512.370(d) according to the following amounts and schedules in Table 1 and Table 2 to § 512.380.
Table 1 to § 512.380—Facility PPA Amounts and Schedule
MPS Performance payment adjustment period
1 and 2 (%) 3 and 4 (%) 5 and 6 (%) 7 (%)
Facility Performance Payment Adjustment ≤6 +4.0 +5.0 +6.0 +7.0
≤5 +2.0 +2.5 +3.0 +3.5
≤3.5 0 0 0 0
≤2 −2.5 −3.0 −3.5 −4.5
≤.5 −5.0 −6.0 −7.0 −9.0
Table 2 to § 512.380—Clinician PPA Amounts and Schedule
MPS Performance payment adjustment period
1 and 2 (%) 3 and 4 (%) 5 and 6 (%) 7 (%)
Clinician Performance Payment Adjustment ≤6 +4.0 +5.0 +6.0 +7.0
≤5 +2.0 +2.5 +3.0 +3.5
≤3.5 0 0 0 0
≤2 −2.5 −3.0 −3.5 −4.0
≤.5 −5.0 −6.0 −7.0 −8.0
Collected 2026-08-27T02:26:11Z. Source file · JSON