ACO provider/supplier

ACO provider/supplier means an individual or entity that meets all of the following:
(1) Is a -
(i) Provider (as defined at § 400.202 of this chapter); or
(ii) Supplier (as defined at § 400.202 of this chapter).
(2) Is enrolled in Medicare.
(3) Bills for items and services furnished to Medicare fee-for-service beneficiaries during the agreement period under a Medicare billing number assigned to the TIN of an ACO participant in accordance with applicable Medicare regulations.
(4) Is included on the list of ACO providers/suppliers that is required under § 425.118.


42 CFR § 425.20

Scoping language

As used in this part, unless otherwise indicated -

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