---
kind: "section"
citation: "42 C.F.R. § 425.100"
title: "42"
number: "425.100"
heading: "General."
url: "https://uscodex.org/cfr/42/425.100"
---

# §425.100. General.

- (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](/cfr/42/425.604.md), [425.605](/cfr/42/425.605.md) (except as provided under [§ 425.605(h)](/cfr/42/425.605.md?p=h)), 425.606, 425.609, or 425.610.
  - (2) The ACO meets the minimum quality performance standards established under [§ 425.500](/cfr/42/425.500.md) (for performance years or a performance period beginning on or before January 1, 2020), or under the quality performance standard established under [§ 425.512](/cfr/42/425.512.md) (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](/cfr/42/425.605.md), [§ 425.606](/cfr/42/425.606.md), [§ 425.609](/cfr/42/425.609.md) or [§ 425.610](/cfr/42/425.610.md) must share losses with the Medicare program under [subpart G](/cfr/42/subpartG.md) of the part.
- (d) An ACO is eligible to receive advance investment payments if it meets the criteria under [§ 425.630(b)](/cfr/42/425.630.md?p=b).
- (e) An ACO is eligible to receive prepaid shared savings if it meets the criteria under [§ 425.640(b)](/cfr/42/425.640.md?p=b).

## Notes

### Amendments

[76 FR 67973, Nov. 2, 2011, as amended at 80 FR 32834, June 9, 2015; 83 FR 60092, Nov. 23, 2018; 83 FR 68083, Dec. 31, 2018; 85 FR 85038, Dec. 28, 2020; 87 FR 70232, Nov. 18, 2022; 89 FR 98566, Dec. 9, 2024]

### Authority

Authority: 42 U.S.C. 1302, 1306, 1395hh, and 1395jjj.

### Source

Source: 76 FR 67973, Nov. 2, 2011, unless otherwise noted.

### Amendments

[76 FR 67973, Nov. 2, 2011, as amended at 80 FR 32834, June 9, 2015; 83 FR 60092, Nov. 23, 2018; 83 FR 68083, Dec. 31, 2018; 85 FR 85038, Dec. 28, 2020; 87 FR 70232, Nov. 18, 2022; 89 FR 98566, Dec. 9, 2024]