New CMS Qualifying APM Participant Look-Up Tool

October 6, 2017
Policy Snapshot
Centers for Medicare and Medicaid (CMS), Payment, Alternative Payment Models (APM), Medicare Access and CHIP Re-authorization Act (MACRA)

This week the Centers for Medicare & Medicaid Services (CMS) announced the results of the first Qualifying APM Participant (QP) determinations based on eligible clinician participation in the 2017 Advanced Alternative Payment Models (APMs). CMS unveiled an interactive look-up tool where many 2017 Advanced APM participants can look up their QP status based on calculations from claims with dates of service between 1/1/17 and 3/31/17 for the first QP snapshot.

Under the Quality Payment Program, eligible clinicians who meet certain criteria are considered QPs in Advanced APMs, and are therefore excluded from the MIPS quality reporting program. QPs identified based on the 2017 performance year will receive a 5 percent lump sum Medicare incentive payment in 2019. The tool will be updated soon with calculations from claims with dates of services between 1/1/17 and 6/30/17.