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.

Frequently Asked Questions Updated for 2023


3. Who am I going to be compared to?

  1. Your performance will be compared to CMS’s defined list of “eligible clinicians” who are subject to participation in the MIPS program, regardless of specialty. To be eligible to receive a positive payment adjustment, you must exceed the minimum performance threshold set by CMS for each performance year (for 2023 the performance threshold is 75 points). Once you exceed the performance threshold, the specific percent amount of the payment adjustment that will be applied to your Medicare Part B FFS claims two years later in the payment adjustment year (i.e., 2025 payment adjustment year based on 2023 performance) will depend on how you performed in comparison to your peers. Additionally, there must be budget neutrality, so the total amount of positive payment adjustments must be equal to the total amount of the negative payment adjustments.

    View PAI’s How QPP Affects Medicare Part B Payment resource for additional details.  

Comments are closed.