How to differentiate capitated amounts for services based on factors like age, geo location, and other factors?

[SatyaKomatineni]

Hello,
On the capitated in network file there

capitation id (or description): Office services
Provider 1: $40
provider 2: $60

What happens if the office services are more like:

capitation id (or description): Office services for < 18 years old for Jacksonville
Provider 1: $40
provider 2: $60

capitation id (or description): Office services for < 18 years old for NY
Provider 1: $400
provider 2: $600

Questions:

1. is this acceptable?
2. is the amount per member per month of capitation?

Appreciate it
Satya

[Kam-cog]

Note: I am not an expert but happened to read the rules in detail today and made notes for every reimbursement type thats described in the final rules - page 246 onwards.

Here is an example of reimbursement illustration that they have given which is based on a percentage which would vary based on the characteristics of Enrollee and provider. This is the closest match i could get. It states that for value based reimbursements, the base negotiated rate should suffice and the plans need not publish the other value based factors calculation .
The below is taken AS IS from the rules.
Example:a plan calculates provider reimbursement using a reference-based
pricing model that sets reimbursement to Provider X at 120 percent of the Medicare rate for
covered Item A. The reference-based percentage used to determine the base negotiated rate
would be 120 percent. In the general course of business, the plan determines the Medicare rate
for Item A using participant, beneficiary, or enrollee-specific characteristics, but, because there is
no specific participant, beneficiary, or enrollee for purposes of populating the In-network Rate
File, the plan or issuer must report the base negotiated rate that would apply prior to application
of any participant, beneficiary, or enrollee-specific characteristics. In this example, the Medicare
rate for Item A is $150, before applying adjusters for participant, beneficiary, or enrollee-specific
characteristics. Therefore, the plan would report a negotiated rate for Item A when received
from Provider X of $180 ($150 multiplied by 120 percent) and must include this rate in the In
network Rate File.

[tdfow]

I understood the mandate to state that if the capitation arrangement is weighted upon characteristics, such as age, gender, then the rate that is published should be before any adjustments are made---there is a reference to 'notate' any entries that represent the items/services that associate with this capitation amount---but unclear how this would be 'notated' to show it has weighted characteristics (if this should be addressed).

[ks2178o2]

Are there specific directives on how to address these cases now?