Earn a Medicare Peak Performance Incentive Bonus

Fidelis Care is offering a bonus to providers who deliver and appropriately document quality care to its members. The Peak Performance Program is part of Fidelis Care’s initiative to recognize providers who improve the overall health outcomes of Medicare members during the measurement period of August 1, 2021 to December 31, 2021. Providers can potentially earn a bonus by scheduling appointments with members to address targeted measures, including:

  • Diabetes HbA1c<=9
  • Diabetes – Dilated Eye Exam
  • Colorectal Cancer Screen
  • Mammogram
  • Statin Therapy for Patients with Cardiovascular Disease
  • Diabetes Monitor Nephropathy
  • Care of Older Adult – Medication Review*
  • Care of Older Adult – Pain Assessment*
*Dual Eligible Special Needs Plan (DSNP) members only

Bonuses are triggered through the normal provider/plan submission of claims/encounters. Fidelis care asks providers to schedule and conduct an exam with the impacted members by December 31, 2021 to address the target measure(s). Upon completion of the examination, document care and diagnosis in the patient’s medical record and submit the claim/encounter containing all relevant ICD 10, CPT and/or CPT II codes by January 31, 2022. Payment will be made by summer 2022.

Please note that some contracts are excluded from Peak Performance and additional conditions for eligibility to receive a Bonus under the Peak Performance Program may apply. 
To download an informational flyer on the Peak Performance Program, please click here.