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Variable: ACO-RED-CAGC

Pioneer Accountable Care Organization (ACO) Reduction Group Code

Source System Definition

If the claim has a demonstration code equal to “59” (Pioneer ACO Demonstration) or “68” (Pioneer ACO SNF), and provided service is from an outpatient provider (TOB equal to 12, 13, 14, 22, 23, 34, 71, 72, 74, 75, 76, 77, 81, 82, 85) or the service is for home health Part B; this field will identify the applicable adjustment group code that defines the liability for adjustments in charges occurring from this payment reduction.

Other Info

  • Source System: FISS
  • Source Field: Pioneer Accountable Care Organization (ACO) Reduction Group Code
  • Version: 0.12

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