• Expecting an APM Bonus? Ensure CMS Knows Where to Send It

    Nov. 1 Is Deadline to Submit Billing Information to Agency

    October 13, 3:40 pm News Staff – Physicians participating in CMS’ Quality Payment Program, take note: To those who qualified for an Advanced Alternative Payment Model bonus for the 2018 performance year, those payments started rolling out last month, and you should receive yours soon. If, that is, CMS has the correct billing information on file for you. 

    5 percent figure

    As defined by QPP, eligible clinicians who meet the applicable payment amount or patient count thresholds in an Advanced APM for a given performance year are considered Qualifying APM Participants for that year and may be eligible for a 5% bonus payment. Those payments, which are based on the paid amounts for Medicare Part B-covered professional services, are made two years after the performance period.

    CMS began notifying 2018 QPs last month of their eligibility to receive a 5% APM bonus in 2020. The agency also sent letters to QPs for whom current Medicare billing information could not be verified and published a list of all QPs the agency hasn’t been able to complete payments to. Download the 2020 QP Notice for APM Incentive Payment zip file to obtain the list as an Excel spreadsheet, along with instructions for updating your billing information and required forms.

    If you received one of those letters or your name is on the list, you need to provide your billing information and accompanying forms no later than Nov. 13 to ensure you receive your bonus.

    According to Erin Solis, AAFP manager of practice and payment, for those who earned a 5% bonus but are on the CMS list, “It’s basically claim it or lose it.

    “If they did the work, they should make sure they’ve gotten the bonus,” she told AAFP News.

    Completed forms must be emailed to the QPP APM Help Desk at QualityPaymentProgramAPMHelpdesk@cms.hhs.gov. Forms submitted through any other means will not be accepted or processed.

    Contact the Help Desk at 866-288-8292 with questions about the submission process. For help determining what information is required, consult the Medicare Provider, Enrollment, Chain and Ownership System or contact your Medicare Administrative Contractor. Additional information, including a QP Methodology Fact Sheet and 2020 Incentive Payment Fact Sheet, may be downloaded from the QPP website. 

    QPs who have not been notified about difficulties with their APM bonus payment may log in to the QPP portal to review details of the payment.