Source: https://www.law.cornell.edu/cfr/text/42/425.404
Timestamp: 2020-07-06 18:34:39
Document Index: 386805258

Matched Legal Cases: ['§ 425', '§ 425', '§ 425', '§ 425', '§ 425', '§ 425', '§ 425']

42 CFR § 425.404 - Special assignment conditions for ACOs including FQHCs and RHCs. | CFR | US Law | LII / Legal Information Institute
Subpart E. Assignment of Beneficiaries
Section 425.404. Special assignment conditions for ACOs including FQHCs and RHCs.
42 CFR § 425.404 - Special assignment conditions for ACOs including FQHCs and RHCs.
§ 425.404 Special assignment conditions for ACOs including FQHCs and RHCs.
CMS assigns beneficiaries to ACOs based on services furnished in FQHCs or RHCs or both consistent with the general assignment methodology in § 425.402, with special conditions:
(a) For performance years 2012 through 2018 -
(2) Under the assignment methodology in § 425.402, CMS treats a service reported on an FQHC/RHC claim as a primary care service -
(i) If the claim includes a HCPCS or revenue center code that meets the definition of primary care services under § 425.20;
(b) For performance years starting on January 1, 2019, and subsequent performance years, under the assignment methodology in § 425.402, CMS treats a service reported on an FQHC/RHC claim as a primary care service performed by a primary care physician.