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So in this case, the patient has intense symptoms of withdrawal due to cessation of alcohol use and does not have signs of other severe disorders such as seizures and hallucinations
July 8, 2025
(d) Identification of the payment amount in the payment amount benchmark quarter
For example, the PCMP TEP discussed general challenges in developing chronic condition episode-based measures and ways that the chronic condition framework can address those challenges, provided feedback on the attribution rules (that is, the algorithms and the types of codes used in each algorithm) that would demonstrate a relationship between a clinician group and a patient with a chronic condition(s), and discussed service assignment, risk adjustment, and exclusions, which support the overall development of episode-based measures, including, but not limited to those episode-based measures being proposed in this rulemaking
If the ACO fails to meet the applicable quality performance standard established in 425.512 or the alternative quality performance standard, the ACO is subject to 1st dollar losses at a rate of 75 percent ( 425.610(f)(4)(ii))
