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However, the modified measure continues to exclude episodes for patients with significant ocular conditions impacting surgical complication rate or visual outcomes because testing did not suggest they had similar enough cost profiles for any expected cost differences to be accounted for through risk adjustment

Response: No, the treating/requesting practitioner and the consulting provider do not have to be in the same organization to furnish interprofessional consultation services

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In the proposed rule, we explained that we believed it would be appropriate to propose to broaden this limited exception and allow a voluntarily ( aligned Shared Savings Program beneficiary to be claims-based assigned to an entity participating in a disease- or condition-specific CMS Innovation Center model when that model uses claims-based assignment that is based on primary care and/or other services