Quality Payment Program Participation Status Tool Now Includes First Snapshot of 2018 Qualifying APM Participant and MIPS APMs Data

Today, the Centers for Medicare & Medicaid Services (CMS) updated its Quality Payment Program Participation Status Tool to include 2018 Qualifying APM Participant (QP) and MIPS APM status. The tool has been updated based on calculations from the first snapshot of data from APM entities. The first snapshot includes data from Medicare Part B claims with dates of service between January 1 and March 31, 2018.

Later this year, CMS will release and announce the second and third QP and MIPS APM status data based on snapshots of claims between January 1 and August 31, 2018. To learn more about how CMS determines QP and MIPS APM status for each snapshot, please view the QP Methodology Fact Sheet.

What Does QP Status and MIPS APM Status Mean?

If you qualify as a QP, this means you are:

Eligible for the 5% APM incentive bonus, and
Exempt from participating in MIPS.

Note: If you are in participating in a MIPS APM (and do not qualify as a QP or Partial QP), you will most likely need to participate in MIPS, but will be subject to the APM Scoring Standard. Check the Quality Payment Program Participation Status Tool to see if you’re eligible for MIPS in 2018.

What APMs are Included in the Quality Payment Program Participation Status Tool?

The updated Quality Payment Program Participation Status Tool includes the following 2018 Advanced APMs and MIPS APMs:

Comprehensive Care Joint Replacement (CJR) Payment Model (Track 1 – CEHRT)
Comprehensive ESRD Care (CEC) - Two-Sided Risk
Comprehensive Primary Care Plus (CPC+)
Next Generation Accountable Care Organization (ACO) Model
Medicare ACO Track 1+ Model
Medicare Shared Savings Program – Track 1
Medicare Shared Savings Program – Track 2
Medicare Shared Savings Program – Track 3

How Do I Check My QP or MIPS APM Status?

To view your QP or MIPS APM status at the individual level:

Go to: https://qpp.cms.gov/participation-lookup
Enter your 10-digit National Provider Identifier (NPI)

To check your group’s 2018 eligibility at the APM entity level:

Log into the CMS Quality Payment Program website with your EIDM credentials
Browse to the Taxpayer Identification Number affiliated with your group
Access the details screen to view the eligibility status of every clinician based on their NPI

Questions?

Contact the Quality Payment Program Service Center by: