Medicare QPP

Physicians Advocacy Institute

These resources have not been updated since 2023 but the general details remain relevant. For a summary of the key changes for CY 2024, please click here.

Background Resources

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QPP Overview

2023 is the seventh year of the Quality Payment Program (QPP) under which physicians will have the opportunity to earn bonuses, or face penalties, in the form of positive, neutral, or negative adjustments based on their performance in quality and cost measures and activities and use of their electronic health records (EHRs). This resource provides a brief overview of the two participation pathways under the QPP.


QPP Resource Navigation Tool

This interactive tool will help you navigate what resources and support organizations are available for QPP if you aren’t sure where to begin or would like additional details on the Merit-based Incentive Payment System (MIPS) or Advanced Alternative Payment Models (APMs).


Guide to Acronymns

This resource provides a guide to the acronyms utilized within the context of the QPP.


Key Changes for the CY 2023 Quality Payment Program

Provides an overview of the CY 2023 QPP Final Rule and key changes from 2023 participation requirements.


Reporting Mechanisms

This resource provides an overview and guidance on the different reporting mechanisms available for reporting MIPS data, including claims, qualified clinical data registries (QCDRs), qualified registries, electronic health records (EHRs), and the CMS QPP Submission Portal.


How QPP Affects Medicare Part B Payments

This resource provides an overview of how your Medicare Part B FFS payments are affected depending on which of the two paths— MIPS or Advanced APMs—you select for QPP participation. If you participate in the MIPS pathway, you will receive either a positive, neutral, or negative payment adjustment; if you successfully participate in the Advanced APM pathway, you will receive an incentive payment for payment years 2019-2024.


Diagram/Landscape of Key Resources and Organizations

Unsure of where or who to go to for more information on QPP, MIPS, and/or Advanced APMs? This resource outlines and lists the QPP “Network of Players,” including, CMS support and practice transformation networks, state medical associations and societies, national specialty societies, measure stewards, etc.


APP Reporting

This resource provides an overview of the APM Performance Pathway (APP), which is a single, pre-determined measure set that MIPS APM participants may report on at the individual, group, and/or APM Entity levels. The APP is an optional MIPS reporting and scoring pathway for MIPS APM participants; however, it is required for all Medicare Shared Savings Program Accountable Care Organizations.