42 CFR §414.1200

1. (a)Basis. This subpart implements section 1848(p) of the Act by establishing a payment modifier that provides for differential payment starting in 2015 to a group of physicians and starting in 2017 to a group and a solo practitioner under the Medicare Physician Fee Schedule based on the quality of care furnished compared to cost during a performance period.
2. (b)Scope. This subpart sets forth the following:
   1. (1)The application of the value-based payment modifier.
   2. (2)Performance and payment adjustment periods.
   3. (3)Reporting mechanisms for the value-based payment modifier.
   4. (4)Alignment of PQRS quality of care measures with the quality measures for the value-based payment modifier.
   5. (5)Additional measures for groups and solo practitioners.
   6. (6)Cost measures.
   7. (7)Attribution for quality of care and cost measures.
   8. (8)Scoring methods for the value-based payment modifier.
   9. (9)Benchmarks for quality of care measures.
   10. (10)Benchmarks for cost measures.
   11. (11)Composite scores.
   12. (12)Reliability of measures.
   13. (13)Payment adjustments.
   14. (14)Value-based payment modifier quality-tiering scoring methodology.
   15. (15)Limitation of review.
   16. (16)Inquiry process.