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CMS Will Begin Applying the Value Modifier in Calendar Year (CY) 2017 to All Physicians

November 25, 2014



CMS will begin applying the Value Modifier in calendar year (CY) 2017 to all physicians; including those in groups with two or more eligible professionals (EPs), and to physicians who are solo practitioners. This policy completes the phase-in of the Value Modifier to all physicians and groups of physicians as required by the statute.

CMS estimates it will affect approximately 900,000 physicians in CY 2017.

  • CMS proposed to increase the maximum downward adjustment under the Value Modifier from -2.0 percent in the CY 2016 payment adjustment period to -4.0 percent for the CY 2017 payment adjustment period for all groups and solo practitioners.
  • In addition, we will increase the maximum downward adjustment under the quality-tiering methodology for groups with ten or more EPs to -4.0 percent for groups of ten or more EPs classified as low quality/high cost and set the adjustment at -2.0 percent for groups classified as either low quality/average cost or average quality/high cost.

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