PCC Fee Reduction definition

PCC Fee Reduction means a full or partial reduction in Medicare FFS payments to those Participant Providers and Preferred Providers participating in PCC Payment for PCC Eligible Services furnished to REACH Beneficiaries to account for the monthly payments made by CMS to the ACO under PCC Payment.
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Examples of PCC Fee Reduction in a sentence

  • The ACO shall ensure that the ACO REACH Model: Fee Reduction Agreement specifies the PCC Fee Reduction or TCC Fee Reduction and, if applicable, the APO Fee Reduction agreed upon by the individual or entity from among the applicable percentages specified in this Section 12.02.

  • If the ACO selected PCC Payment as its Capitation Payment Mechanism for the ACO’s first Performance Year, the ACO shall certify that each individual and entity listed on either the Proposed Participant Provider List or the Proposed Preferred Provider List as participating in PCC Payment at the start of the ACO’s first Performance Year has agreed to a PCC Fee Reduction that is a percentage within the range of 10% and 100%.

  • The ACO shall ensure that each individual and entity listed on the Preferred Provider List as participating in the ACO’s selected Capitation Payment Mechanism at the start of the Performance Year has agreed to a PCC Fee Reduction or TCC Fee Reduction, as applicable, that is a percentage within the range of 1% and 100%.

  • If the ACO selected PCC Payment as its Capitation Payment Mechanism for the ACO’s first Performance Year, the ACO shall certify that each individual and entity listed on either the Proposed Participant Provider List or the Proposed Preferred Provider List as participating in PCC Payment at the start of the ACO’s first Performance Year has agreed to a PCC Fee Reduction that is a percentage within the range of 5% and 100%.

  • Claims data will include data regarding those claims subject to the TCC Fee Reduction (if the DCE has selected TCC Payment as its DC Capitation Payment Mechanism) or the PCC Fee Reduction (if the DCE has selected PCC Payment as its DC Capitation Payment Mechanism) and, if the DCE has selected to participate in the APO, the APO Fee Reduction.