You will continue to bill Medicare in the same way that you do now, the distinction being that claims for certain primary care services included in the PBPM for assigned patients will include a “132” adjustment code and adjustment reason “Prearranged demonstration project adjustment” for any PQEM services billed as defined by Medicare. There is a more elaborate version on page 17-18 here, but essentially Medicare will pay the reduction for any assigned patients, and if they determine that they paid a reduced amount for patients no longer assigned, they’ll re-adjudicate to pay the full amount in the following month. Any non-primary care services will be reimbursed fee-for-service as they are now.