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2025 Medicare Part C & Part D Reporting Requirements & Data Validation

Translating Findings into Scores at the Standard/Sub-Standard & Reporting Section-Level

Table 25 is identical to Table 24 except that the reviewer has found Standard 7 to be "Not Applicable." In this case, no percentage points are included for Standard 7 in either the actual score or the maximum possible score. To calculate the percentage score, CMS will divide the actual score, 98.0000 percent, by the maximum possible score, 99.0000 percent (deducting 1.000% from the normal maximum possible score of 100% because Standard 7 is "Not Applicable," 100.0000% - 1.0000% = 99.0000%), which equals 0.989898, or in percentage terms, 98.9898 percent.

Table 25: Reporting Section Scoring With "Not Applicable" Finding
Standard
(1)		Reviewer's Finding
(2)		Maximum Possible Score
(3)		Actual Score
(4)
1All sub-standards received “Yes” findings or scores of 57.0%7.0%
2All sub-standards and data elements received “Yes” findings or scores of 510.0%10.0%
3All sub-standards and data elements received “Yes” findings80.0%80.0%
4Standard received “Yes” finding1.0%1.0%
5Standard received “No” finding1.0%0.0%
6Standard received “Yes” finding0.0%0.0%
7Standard received “Not Applicable” finding0.0%0.0%
Totals99.0%98.0%
Percentage Score98.9898% (98.0% ÷ 99.0%)

Percentages may not sum to totals due to rounding.

Refer to Section 2.3 of Appendix J for more information on reporting section scores.

Table Description

This table shows the scoring for a reporting section where one standard was found to be "Not Applicable." It includes the maximum possible score and the actual score for each standard based on the reviewer's findings:

  1. Standard 1:
    • All sub-standards received “Yes” findings or scores of 5.
    • Maximum Possible Score: 7.0%
    • Actual Score: 7.0%
  2. Standard 2:
    • All sub-standards and data elements received “Yes” findings or scores of 5.
    • Maximum Possible Score: 10.0%
    • Actual Score: 10.0%
  3. Standard 3:
    • All sub-standards and data elements received “Yes” findings.
    • Maximum Possible Score: 80.0%
    • Actual Score: 80.0%
  4. Standard 4:
    • Standard received “Yes” finding.
    • Maximum Possible Score: 1.0%
    • Actual Score: 1.0%
  5. Standard 5:
    • Standard received “No” finding.
    • Maximum Possible Score: 1.0%
    • Actual Score: 0.0%
  6. Standard 6:
    • Standard received “Yes” finding.
    • Maximum Possible Score: 0.0%
    • Actual Score: 0.0%
  7. Standard 7:
    • Standard received “Not Applicable” finding.
    • Maximum Possible Score: 0.0%
    • Actual Score: 0.0%

Totals:

  • Maximum Possible Score: 99.0%
  • Actual Score: 98.0%
  • Percentage Score: 98.9898% (Calculated by dividing the actual score by the maximum possible score: 98.0% ÷ 99.0%)