42 CFR §425.100
Verified against eCFR.gov as of June 20, 2026View official text on eCFR.gov ↗
- (a)Under the Shared Savings Program, ACO participants may work together to manage and coordinate care for Medicare fee-for-service beneficiaries through an ACO that meets the criteria specified in this part. The ACO must become accountable for the quality, cost, and overall care of the Medicare fee-for-service beneficiaries assigned to the ACO.
- (b)An ACO is eligible to receive payments for shared savings under subpart G of this part if all of the following conditions are met:
- (1)The ACO meets or exceeds the applicable minimum savings rate established under §§ 425.604, 425.605 (except as provided under § 425.605(h)), 425.606, 425.609, or 425.610.
- (2)The ACO meets the minimum quality performance standards established under § 425.500 (for performance years or a performance period beginning on or before January 1, 2020), or under the quality performance standard established under § 425.512 (for performance years beginning on or after January 1, 2021).
- (3)The ACO otherwise maintains its eligibility to participate in the Shared Savings Program under this part.
- (c)ACOs that operate under a two-sided model and meet or exceed a minimum loss rate established under § 425.605, § 425.606, § 425.609 or § 425.610 must share losses with the Medicare program under subpart G of the part.
- (d)An ACO is eligible to receive advance investment payments if it meets the criteria under § 425.630(b).
- (e)An ACO is eligible to receive prepaid shared savings if it meets the criteria under § 425.640(b).