42 CFR § 414.1255 - Benchmarks for cost measures.

---
identifier: "/us/cfr/t42/s414.1255"
source: "ecfr"
legal_status: "authoritative_unofficial"
title: "42 CFR § 414.1255 - Benchmarks for cost measures."
title_number: 42
title_name: "Public Health"
section_number: "414.1255"
section_name: "Benchmarks for cost measures."
chapter_name: "CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES"
subchapter_number: "B"
subchapter_name: "MEDICARE PROGRAM"
part_number: "414"
part_name: "PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES"
positive_law: false
currency: "2026-03-24"
last_updated: "2026-03-24"
format_version: "1.1.0"
generator: "[email protected]"
authority: "42 U.S.C. 1302, 1395hh, and 1395rr(b)(l)."
regulatory_source: "55 FR 23441, June 8, 1990, unless otherwise noted."
cfr_part: "414"
---


# 414.1255 Benchmarks for cost measures.

(a) For the CY 2015 payment adjustment period, the benchmark for each cost measure is the national mean of the performance rates calculated among all groups of physicians for which beneficiaries are attributed to the group of physicians that are subject to the value-based payment modifier. In calculating the national benchmark, groups of physicians' performance rates are weighted by the number of beneficiaries used to calculate the group of physician's performance rate.

(b) Beginning with the CY 2016 payment adjustment period, the benchmark for each cost measure is the national mean of the performance rates calculated among all groups and solo practitioners that meet the minimum number of cases for that measure under § 414.1265(a). In calculating the national benchmark, groups and solo practitioners' performance rates are weighted by the number of beneficiaries used to calculate the group or solo practitioner's performance rate.

[78 FR 74821, Dec. 10, 2013, as amended at 79 FR 68007, Nov. 13, 2014; 80 FR 71384, Nov. 16, 2015]