October 13, 2017
The Centers for Medicare and Medicaid Services (CMS) has posted an interactive tool where 2017 Advanced APM participants can look up their QP status based on calculations from claims with dates of service between 1/1/17 and 3/31/17 for the first QP snapshot. It will be updated soon with calculations from claims with dates of services between 1/1/17 and 6/30/17. To determine QP status, CMS will use claims data from the relevant performance year as of three points in time, or “snapshot” dates: March 31, June 30, and August 31. The tool is available here.
Under the Advanced APM track of the Quality Payment program (QPP) eligible clinicians who are determined to be QPs for a given year will be excluded from MIPS and receive a 5 percent lump sum incentive payment for that year. The APM incentive payment will be available from 2019 through 2024. Beginning in 2026, QPs who participate in an AAPM will receive a 0.75 percent fee schedule update, and all other eligible clinicians will receive a 0.25 percent fee schedule update. Eligible clinicians must meet certain thresholds to be QPs and qualify for incentive payments. For the 2019 and 2020 Payment Years, they must have 25 percent of their Medicare fee-for-service payments or 20 percent of their patients through an eligible alternative payment entity.