October 13, 2017

CMS Qualifying APM Participant Look-Up Tool Now Available

The Centers for Medicare & Medicaid Services (CMS) has unveiled an interactive look-up tool where 2017 Advanced Alternative Payment Model (APM) participants can look up their Qualifying APM Participant (QP) status.

The tool released on Oct. 4 is based on calculations from claims with dates of service between Jan. 1 and March 31 for the first QP determination “snapshot” period. With this tool, you can determine your Merit-based Incentive Payment System (MIPS) eligibility by simply entering a National Provider Identifier (NPI) into the given field and clicking the “FIND QP STATUS BY NPI” button. About 75,000 NPIs are included in this first QP analysis.

CMS will make QP determinations using three snapshot dates: March 31, June 30 and Aug. 31.

The tool will be updated soon with calculations for the second QP snapshot period from claims with dates of services between Jan. 1 and June 30. The third QP snapshot period will occur for the period between Jan. 1 and Aug. 31.

Under the Quality Payment Program (QPP), eligible clinicians who meet certain criteria are considered QPs in Advanced APMs and are 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.