{"data":{"id":"us/42-cfr-414.1230","jurisdiction":"us","citation":"42 CFR 414.1230","heading":"Additional measures for groups and solo practitioners.","body":"The value-based payment modifier includes the following additional quality measures (outcome measures) as applicable for all groups and solo practitioners subject to the value-based payment modifier:\n(a) A composite of rates of potentially preventable hospital admissions for heart failure, chronic obstructive pulmonary disease, and diabetes. The rate of potentially preventable hospital admissions for diabetes is a composite measure of uncontrolled diabetes, short term diabetes complications, long term diabetes complications and lower extremity amputation for diabetes.\n(b) A composite of rates of potentially preventable hospital admissions for dehydration, urinary tract infections, and bacterial pneumonia.\n(c) Rates of an all-cause hospital readmissions measure, except for groups with between two to nine eligible professionals and solo practitioners starting with the CY 2017 payment adjustment period.","path":["Title 42—Public Health","CHAPTER IV—CENTERS FOR MEDICARE \u0026 MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES","SUBCHAPTER B—MEDICARE PROGRAM","PART 414—PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES","Subpart N—Value-Based Payment Modifier Under the Physician Fee Schedule"],"source_url":"https://www.ecfr.gov/api/versioner/v1/full/2026-08-25/title-42.xml","current_through":"2026-08-25","vintage":"","retrieved_at":"2026-08-27T02:26:11Z","sha256":"116306dc3ab03061576f2ba0be6d2ae6116e8b9b11c5f2dcfbf1e27795491b63","source_id":"us-cfr","stale":true,"prev":"us/42-cfr-414.1225","next":"us/42-cfr-414.1235"},"notice":"GroundRules: Original legal text. Not legal advice."}