Capitation
#225
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Has CMS revisited the capitated rates. It isn't clear how this assist a member selecting one an insurance plan. Providers that received capitation do not send in claims for adjudication- they received monthly payments. Capitation also not a 1:1 relationship with a procedure code. Multiple codes could be for the PMPM.
Example- 99075-99429, 99444,99450-99600, 99601-99602 have the same PMPM (based on member's age)
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