8. What is the All-Payer Count? While for the 2017 and 2018 participation years, physicians could only receive credit for APM participation if they were participating in a “Medicare Advanced APM,” (i.e., an APM administered by CMS/CMMI under Medicare Part B), beginning in 2019, physicians who are participating in APM arrangements with other payers (e.g., Medicare Advantage plans), “Other Payer Advanced APMs,” can have that participation count towards the requirements for the QPP Advanced APM pathway. There are four ways for physicians or other eligible clinicians to meet the QP and PQ thresholds. Medicare Payment Count based on the percentage of Medicare payments received through a Medicare Advanced APM Medicare Patient Count based on the percentage of Medicare patients seen through a Medicare Advanced APM All Payer Payment Count based on the percentage of payments received through a Medicare Advanced APM and Other Payer Advanced APM All Payer Patient Count based on the percentage of patients seen through a Medicare Advanced APM and Other Payer Advanced APM For additional information, see the PAI’s Advanced APM Overview. Pages Advanced APMs1. I practice in an ACO/Patient Centered Medical Home (PCMH) part-time but also practice in a different location that is not an ACO/PCMH, am I in an Advanced APM, MIPS or a MIPS APM?2. Is it too late to be in an advanced APM for 2020? 2021?3. If I am in an alternative payment model (such as an ACO), do I still have to participate in MIPS?4. How does CPC+ work with MACRA?5. What Advanced APMs are available in 2020?6. How do I participate in an Advanced APM?7. What is an Other Payer Advanced APM?8. What is the All-Payer Count?9. How is my QP/PQ determination made under the Medicare Count Methods and/or All-Payer Count Methods? Comments are closed.
