2019 Quality Payment Program (QPP) - MIPS and Advanced APMS

The Centers for Medicare and Medicaid Services (CMS) has developed the Quality Payment Program (QPP) for clinicians who bill Medicare Part B. QPP has two tracks:

  • The Merit-based Incentive Payment System (MIPS)
  • Advanced Alternative Payment Models (APMs)

Eligible clinicians, who participate in MIPS 2019 (QPP Year 3) and exceed the performance threshold (30 points for 2019), will be eligible for a payment adjustment up to +7% in 2021. Eligible clinicians who do not participate will receive a -7% payment adjustment in 2021. Eligible clinicians’ MIPS 2019 performance will be publicly available on Physician Compare.

An APM is a payment approach that trends away from the fee-for-service model and toward value-based-care. An Advanced APM takes this model one step further and requires practices to take on financial risk related to their patient’s outcomes.

Contact your QIA or send an email to optometry.ptn@umassmed.edu

Overview of Transition Year 2019 MIPS program and eligibility requirements.

Find resources, support and help for CMS and the Quality Payment Program.