42 CFR § 512.380 - PPA Amounts and schedules.

§ 512.380 PPA Amounts and schedules.

CMS adjusts the payments described in § 512.375 based on the ETC Participant's MPS calculated as described in § 512.370(d) according to the following amounts and schedules in Table 1 and Table 2 to § 512.380.

Table 1 to § 512.380—Facility PPA Amounts and Schedule

MPS Performance payment adjustment period
1 and 2
(%)
3 and 4
(%)
5 and 6
(%)
7
(%)
Facility Performance Payment Adjustment ≤6 +4.0 +5.0 +6.0 +7.0
≤5 +2.0 +2.5 +3.0 +3.5
≤3.5 0 0 0 0
≤2 −2.5 −3.0 −3.5 −4.5
≤.5 −5.0 −6.0 −7.0 −9.0

Table 2 to § 512.380—Clinician PPA Amounts and Schedule

MPS Performance payment adjustment period
1 and 2
(%)
3 and 4
(%)
5 and 6
(%)
7
(%)
Clinician Performance Payment Adjustment ≤6 +4.0 +5.0 +6.0 +7.0
≤5 +2.0 +2.5 +3.0 +3.5
≤3.5 0 0 0 0
≤2 −2.5 −3.0 −3.5 −4.0
≤.5 −5.0 −6.0 −7.0 −8.0
[85 FR 61362, Sept. 29, 2020, as amended at 90 FR 53142, Nov. 24, 2025]