Capitation is a method used to make payment to managed care plans through a pre-paid, flat monthly fee for each covered person. The payment is independent of the number of services received, or the costs incurred by a provider in furnishing those services.

The system assigns a capitation category for each payment that is made for each recipient. The designated category is based on a variety of factors including, but not limited to, a recipient's eligibility program, Medicare status, age, and in some cases, gender.

Capitation Categories (by type of Managed Care Organization)
*Click a link to download the capitation spreadsheet.