{
 "id": "cms:c3e8e9c3-5193-47fb-a5bb-d3ddb00e7197",
 "slug": "value-modifier",
 "source": "data.cms.gov",
 "title": "Value Modifier",
 "summary": "The Medicare Value-Based Payment Modifier (Value Modifier) data contains the performance results of de-identified practices that were subject to the Value Modifier, such as the practices' quality and cost tiers along...",
 "description": "The Medicare Value-Based Payment Modifier (Value Modifier) data contains the performance results of de-identified practices that were subject to the Value Modifier, such as the practices' quality and cost tiers along with any applicable Value Modifier payment adjustment. The Value Modifier provided for differential payment under the Medicare Physician Fee Schedule based on the quality of care furnished to Medicare beneficiaries compared to the cost of care during a performance period. Calendar Year 2015 was the first payment adjustment period under the Value Modifier based on performance in 2013. Calendar Year 2018 was the final payment adjustment period under the Value Modifier based on performance in 2016.",
 "aliases": [],
 "keywords": [
  "Medicare",
  "Original Medicare",
  "Value-Based Care",
  "Payment Models"
 ],
 "themes": [
  "Medicare"
 ],
 "topics": [
  "spending-utilization",
  "quality",
  "aco-value-based"
 ],
 "category": "medicare-value-based-payment-modifier-program",
 "publisher": "Office of Enterprise Data and Analytics (OEDA)",
 "contact": "qpp@cms.hhs.gov",
 "landing_url": "https://data.cms.gov/medicare-value-based-payment-modifier-program/value-modifier",
 "csv_url": "https://data.cms.gov/sites/default/files/2020-07/Value_Modifier_PUF_Performance_Year_2016.csv",
 "api_url": "https://data.cms.gov/data-api/v1/dataset/c3e8e9c3-5193-47fb-a5bb-d3ddb00e7197/data",
 "api_kind": "cms-data-api",
 "preview_url": "https://data.cms.gov/data-api/v1/dataset/c3e8e9c3-5193-47fb-a5bb-d3ddb00e7197/data?size=10",
 "dictionary_url": "https://data.cms.gov/resources/value-modifier-data-dictionary",
 "dictionary_kind": "page",
 "methodology_urls": [
  "https://data.cms.gov/resources/2018-value-modifier-performance-year-2016-methodology"
 ],
 "state_column": "state",
 "row_count": 207151,
 "posted": "2025-09-11",
 "modified": "2025-09-11",
 "period_start": "2013-01-01",
 "period_end": "2016-12-31",
 "latest_period": "2016-01-01 to 2016-12-31",
 "cadence": "annually",
 "next_update": null,
 "versions": [
  {
   "label": "2016-12-01",
   "uuid": "c3e8e9c3-5193-47fb-a5bb-d3ddb00e7197",
   "posted": "2025-09-11",
   "period_start": "2016-01-01",
   "period_end": "2016-12-31"
  },
  {
   "label": "2015-12-31",
   "uuid": "45a5e2fd-2846-480b-a5e3-de22e2fd2320",
   "posted": "2022-08-04",
   "period_start": "2015-01-01",
   "period_end": "2015-12-31"
  },
  {
   "label": "2014-12-31",
   "uuid": "52d91cf6-19ec-4721-b03e-d031b5af54ed",
   "posted": "2022-08-04",
   "period_start": "2014-01-01",
   "period_end": "2014-12-31"
  },
  {
   "label": "2013-12-31",
   "uuid": "6abfab7c-deb8-4de0-bc99-f895f71bad57",
   "posted": "2022-08-04",
   "period_start": "2013-01-01",
   "period_end": "2013-12-31"
  }
 ],
 "columns": [
  {
   "name": "practice_id",
   "label": "Unique identifier of practice",
   "type": "string",
   "meaning": "Unique identifier of practice",
   "source": "cms-dictionary"
  },
  {
   "name": "state",
   "label": "Location (state) of practice",
   "type": "string",
   "meaning": "State in which practice is located",
   "source": "cms-dictionary"
  },
  {
   "name": "num_eps_vm",
   "label": "Practice EP count category",
   "type": "string",
   "meaning": "Practice eligible professional count category. 0 EPs=Zero eligible professionals. 1-9 EPs=One to nine eligible professionals. 10 to 99 EPs=10 to 99 eligible professionals. 100+ EPs=100 or more eligible professionals.",
   "source": "cms-dictionary"
  },
  {
   "name": "mssp",
   "label": "Practice enrolled in MSSP",
   "type": "number",
   "meaning": "Indicator for whether practice was a Medicare Shared Savings Program Accountable Care Organization practice in the performance year. Value equals 1 if practice was a Medicare Shared Savings Program Accountable Care Organization practice in the performance year. If not, the value equals 0.",
   "source": "cms-dictionary"
  },
  {
   "name": "gpro",
   "label": "GPRO practice",
   "type": "number",
   "meaning": "Indicator for whether practice registered to report data to the PQRS via the Group Practice Reporting Option (GPRO). Value equals 1 if practice registered to report data to the PQRS via the Group Practice Reporting Option (GPRO). If not, the value equals 0.",
   "source": "cms-dictionary"
  },
  {
   "name": "elig_up_adjust",
   "label": "Eligible for high-risk bonus adjustment",
   "type": "string",
   "meaning": "Indicator for whether practice eligible for additional upward payment adjustment for treating disproportionate share of high-risk beneficiaries. N/A=Practice did not meet minimum PQRS reporting requirements in the performance year. Eligible=Practice eligible for additional upward payment adjustment for treating disproportionate share of high-risk beneficiaries. Not Eligible=Practice not eligible for additional upward payment adjustment for treating disproportionate share of high-risk beneficiaries.",
   "source": "cms-dictionary"
  },
  {
   "name": "category",
   "label": "Practice met minimum PQRS reporting requirements",
   "type": "string",
   "meaning": "Practice met minimum PQRS reporting requirements in the performance year. CAT1=Practice subject to the Value Modifier and met minimum PQRS reporting requirements in the performance year. CAT2=Practice subject to the Value Modifier and did not meet minimum PQRS reporting requirements in the performance year.",
   "source": "cms-dictionary"
  },
  {
   "name": "vm_payment_adj",
   "label": "Value Modifier payment adjustment",
   "type": "number",
   "meaning": "Value Modifier payment adjustment for practices subject to the Value Modifier. AF=Adjustment Factor",
   "source": "cms-dictionary"
  },
  {
   "name": "updated_vm",
   "label": "Updated Value Modifier payment adjustment",
   "type": "number",
   "meaning": "Value Modifier payment adjustment, incorporating Informal Review change, if applicable. AF=Adjustment Factor",
   "source": "cms-dictionary"
  },
  {
   "name": "cost_comp_tier_text",
   "label": "Cost Composite Tier: High, Average, Low, N/A",
   "type": "string",
   "meaning": "Cost Composite Tier value determined based on Cost Composite Score (High, Average, Low, N/A). N/A*=Practice did not meet minimum PQRS reporting requirements in the performance year. Low=Practice's Cost Composite Score is at least one standard deviation below benchmark and statistically significantly different from benchmark. Average*=Practice's Cost Composite Score is less than one standard deviation away from the benchmark, practice's Cost Composite Score is at least one standard deviation from benchmark but not statistically significantly different from benchmark, or practice does not have at least minimum number of eligible cases for any cost measures included in Cost Composite. High=Practice's Cost Composite Score is at least one standard deviation above benchmark and statistically significantly different from benchmark.",
   "source": "cms-dictionary"
  },
  {
   "name": "qual_comp_tier_text",
   "label": "Quality Composite Tier: High, Average, Low, N/A",
   "type": "string",
   "meaning": "Quality Composite Tier value determined based on Quality Composite Score (High, Average, Low, N/A). N/A*=Practice did not meet minimum PQRS reporting requirements in the performance year. Low=Practice's Quality Composite Score is at least one standard deviation below benchmark and statistically significantly different from benchmark. Average*=Practice's Quality Composite Score is less than one standard deviation away from the benchmark, practice's Quality Composite Score is at least one standard deviation from benchmark but not statistically significantly different from benchmark, or practice does not have at least minimum number of eligible cases for any quality measures with prior-year benchmark included in Quality Composite. High=Practice's Quality Composite Score is at least one standard deviation above benchmark and statistically significantly different from benchmark.",
   "source": "cms-dictionary"
  },
  {
   "name": "zb_cost_cmpscr_pool_rnd",
   "label": "(Rounded) Standardized Cost Composite Score",
   "type": "number",
   "meaning": "Standardized Cost Composite Score, rounded to the nearest 0.01",
   "source": "cms-dictionary"
  },
  {
   "name": "zb_qual_cmpscr_pool_rnd",
   "label": "(Rounded) Standardized Quality Composite Score",
   "type": "number",
   "meaning": "Standardized Quality Composite Score, rounded to the nearest 0.01",
   "source": "cms-dictionary"
  }
 ],
 "caveats": [],
 "curated": false,
 "license": "https://www.usa.gov/government-works",
 "detail_key": "c3e8e9c3-5193-47fb-a5bb-d3ddb00e7197|2025-09-11",
 "checked": "2026-10-25",
 "source_name": "data.cms.gov"
}