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- Advanced Alternative Payment Model Incentive Extended by CMS
Because of Congress’s actions in the December 2022 omnibus bill, the CMS announced that the incentives for the Advanced Alternative Payment Model (APM) will be extended until the payment year 2025 for participating physicians.
In December 2022, Congress enacted the APM Consolidated Appropriations Act, extending the APM Medicare incentive of a 3.5%through 2025. Without this there would have been a one-year gap with no statutory incentives for Advanced APM participation for the payment year 2025.
For the 2023 performance period and the associated 2025 payment year, the APM incentive will decrease from 5.0% to 3.5%. Additionally, the qualifying participant payment amount and patient count thresholds for participation in Advanced APMs will remain frozen at 50% and 35%, respectively, for the performance period 2023.
What Do I Need to Do to Receive the APM Incentive Payment?
If you meet the requirements to be a qualifying participant in the 2023 performance period, you will not need to do anything to receive your payment in 2025 unless the CMS cannot verify your Medicare billing information.
If you do not receive your payment after initial payments are made, a public notice will be posted with a list of names that indicates that you will need to verify your Medicare billing information. If you do not verify your Medicare billing information by the date in the notice, then the CMS will not be able to issue your APM incentive.
For more information, check out the Frequently Asked Questions on the QPP website or contact the Quality Payment Program at QPP@cms.hhs.gov or 1-866-288-8292.