US · guidance
CMS Pub. 100-11, ch. 13, § 30.1
Part A and Part B of Medicare
CMS makes a prospective monthly payment to the PACE organization of a capitation
amount for each Medicare participant in the payment area. Prospective payments are
made up of the pre-ACA county rate, unadjusted for Indirect Medical Education (IME),
and multiplied by the sum of the individual risk score and the organization frailty score.
This payment methodology is described in the PACE program agreement. The following
three sections provide a brief description of PACE payment and the differences between
PACE payment and payment for other Medicare Advantage plans.
History
(Rev. 2, Issued: 06-09-11; Effective: 06-03-11; Implementation: 06-03-11)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
8af5b043a3122859397ab4e6b36b11982da400484535100bef61c063d095e033
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