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Friday Jul 23, 2021

Here’s how to find out if you’re a 2021 qualifying participant for Medicare’s Alternative Payment Model

The Centers for Medicare & Medicaid Services (CMS) updated its Quality Payment Program Participation Status Tool(qpp.cms.gov) this month based on the first snapshot of 2021 Alternative Payment Model (APM) data. The data is from Medicare Part B claims with dates of service between Jan. 1 and Mar. 31. The tool now allows users to look up their 2021 APM Qualifying Participant (QP) status and Merit-based Incentive Payment System (MIPS) participation status.

If you qualify as a QP, you are:

To view your individual QP or APM participation status:

To check your 2021 eligibility at the APM entity level:

To learn more about how CMS determines QP and the APM participation status for each snapshot of data, visit the APM Determination webpage(qpp.cms.gov) on the QPP website(qpp.cms.gov). For more information on APMs, visit the QPP APM webpages(qpp.cms.gov). For a comprehensive list of APMs (PDF)(lnks.gd), 2021 Learning Resources for QP Status and APM Incentive Payment (ZIP)(lnks.gd), and additional materials, visit the QPP Resource Library(qpp.cms.gov).

If you have questions, you can contact the Quality Payment Program at 1-866-288-8292 from 8 a.m. to 8 p.m. ET Monday through Friday, or via e-mail at QPP@cms.hhs.gov. Individuals who are hearing impaired can dial 711 to be connected to a TRS Communications Assistant.

— Kent Moore, Senior Strategist for Physician Payment

Posted at 11:45PM Jul 23, 2021 by Kent Moore

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