Some physicians need to verify billing info with CMS to receive AAPM bonus

Physicians who qualified for the Advanced Alternative Payment Model (AAPM) bonus for the Quality Payment Program’s (QPP) 2018 performance period will receive their payments soon. But some will have to verify their billing information to ensure they get their bonus.

The Centers for Medicare & Medicaid Services (CMS) started distributing payments to qualified participants (QPs) this month. But CMS also sent letters to QPs for whom the agency could not verify current Medicare billing information. CMS also published a list of those physicians’ NPIs, which is available here. If you received a letter and/or are on the list, you will need to provide your information to CMS by Nov. 13, 2020. CMS provided instructions and the required form in the letter, but you can also find them here. Forms MUST be submitted to the QPP Help Desk at QualityPaymentProgramAPMHelpdesk@cms.hhs.gov. Forms sent to CMS through any other means will not be accepted or processed.

Other QPs can log in to the QPP portal to see the details of the payment and the organization that received the payment.

Eligible clinicians with sufficient participation in an AAPM are considered QPs and eligible for a 5% bonus payment. Payments are made two years after the performance period (e.g., 2020 bonus payments are based on the 2018 performance period). The AAPM bonus is based on the paid amounts for Medicare Part B covered professional services provided by QPs across all their TIN/NPI combinations during the base period. The base period for 2018 bonus payments was Jan. 1-Dec. 31, 2019.

If you have questions about the submission requirements, you can contact the QPP Help Desk at 866-288-8292. For assistance identifying the necessary information, you can use the Medicare Provider, Enrollment, Chain, and Ownership System (PECOS) or contact your Medicare Administrative Contractor (MAC). Additional information, including a QP Methodology Fact Sheet and 2020 Incentive Payment Fact Sheet, are available on the QPP website.

— Erin Solis, Manager of Practice & Payment, American Academy of Family Physicians