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Friday Feb 23, 2018

Performance scores for 2017 QPP claims data are now available

If you used claims to submit 2017 quality data for the Merit-based Incentive Payment System (MIPS), you can now find out how you did.

Eligible physicians can log in to the Quality Payment Portal Program (QPP) Portal( to view their performance scores. The Centers for Medicare & Medicaid Services (CMS) automatically calculates the scores so no additional actions are needed. You can login to the QPP Portal using your Enterprise Identity Data Management (EIDM) credentials. Scores may change monthly depending on the processing of additional 2017 claims. But reviewing your performance score can help you verify that you successfully submitted your data and that you have avoided the negative payment adjustment in 2019. As a reminder, all 2017 claims intended for use in MIPS must be submitted and processed by March 1. Physicians can reach out to their local Medicare Administrative Contractor (MAC)( for specific instructions on how to bill.

While the deadline to submit 2017 data is approaching, physicians still have time to start collecting data for the 2018 performance period. The 2018 performance period requires a full year of quality data. Claims reporting requires the submission of quality data codes (QDCs). If reporting with claims, it is important to review the measure specification sheets to identify any updates to the QDCs. The measure specifications can be found in the QPP resource library(

As the performance period progresses, you should review your explanation of benefits (EOBs) to verify that your QDCs were accepted. You should see the denial code N620 on the QDC line item, which indicates that the code you used is valid for the 2018 performance period. This does not guarantee that the code is the correct code for that particular measure, but it does let you know your codes are being successfully processed and not being dropped from the claim. CMS has created several resources to help physicians understand the claims reporting requirements, which are available in the Quality Measure Specifications Supporting Documents(

– Erin Solis, Regulatory Compliance Strategist for the American Academy of Family Physicians

Posted at 05:45PM Feb 23, 2018 by Erin Solis

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