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US · guidance

CMS Pub. 100-04, ch. 12, § 90.4.4

Payment

activein force · 2026-08-25 – presentas-observed

The incentive payment is 10 percent of the amount actually paid, not the approved amount.

A/B MACs (B) pay the incentive payment for services identified on either assigned or

unassigned claims.

They do not include the incentive payment with each claim payment. A/B MACs (B) should:

• Establish a quarterly schedule for issuing incentive payments. These payments are

taxable and must be reported to the IRS; and

• Prepare a special incentive remittance to accompany each payment. Include a line-item

for each assigned claim represented in the incentive check and a “summary” item

showing the number of unassigned claims represented. Claims should be identified as

HPSA physician, Scarcity, HSIP and/or PCIP in the summary. The sum of the line-items and the “summary” item should equal the amount of the check.

History

(Rev. 2040, Issued: 08-27-10, Effective: 01-01-11 and 04-04-11, Implementation: 01-03-11 for the claim identification of the incentive and 04-04-11 for full implementation)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
7b36fabf2ab6731e93512b6025b137b13bd671fc1e0b1f9932846e1fec147580
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