Medicare Managed Care Manual (Pub. 100-16), Ch. 18a § 10.3.2
Interim Per Capita Rate
10.3.2 - Interim Per Capita Rate
(Rev. 30, 09-05-03)
The interim per capita rate for an HCPP is determined by dividing estimated
reimbursable costs of providing Medicare-covered services to the HCPP's Medicare
enrollees by projected Medicare enrollee months for the reporting period. Estimated
reimbursable costs and the projected number of Medicare enrollee months are derived
from the HCPP's annual operating budget and enrollment forecast. The number of
Medicare enrollees may be compared to CMS' latest updated records of enrollment for
reasonableness. These records will identify the number of Medicare beneficiaries CMS
has identified as enrollees of the HCPP.