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Under the current methodology, the adjustment that will apply in the establishment of benchmarks for ACOs entering an agreement period beginning on January 1, 2024, and in subsequent years, is calculated as follows: Step 1: Calculate capped regional adjustment expressed as a single dollar value as specified in 425.656

While requiring MDPP suppliers to add a modifier to indicate that a claim is for a MDPP same day make-up session does add complexity because we have proposed to use an existing CPT modifier in use and recognized by the MACs, we expect this addition to require minimal changes in claim processing systems

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CMS would also be able to review an ACO's spend plan at any time and require the ACO to modify its spend plan to comply with the requirements of 425.640(d) and (i)

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