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Quality Payment Program for Pathologists

Performance in Medicare’s Quality Payment Program (QPP) determines whether a pathologist will receive more or less money for the services they provide to Medicare beneficiaries. We are committed to ensure pathologists can be successful in the QPP and its Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Model (APM) programs. These two payment pathways for QPP eligible participants allow physicians to increase their future Medicare reimbursements, but also penalize those physicians who do not meet performance objectives.

Why Should Pathologists Care about Participating in MIPS?

QPP Eligibility and Preparedness

Individual pathologists and group practices can check their eligibility in the QPP with Medicare’s lookup tool developed by the Centers for Medicare & Medicaid Services (CMS). Additionally, we provide resources to help pathologists comply with MIPS and APMs payment models.

QPP Phases of Participation, General Timeline, and Action

QPP Phases of ParticipationGeneral Timeline and Action
Phase 1: Performance MeasurementReporting period begins on January 1 and ends on December 31 each year.
Clinicians care for patients and record measure data during the reporting period.
Phase 2: Submit DataRegistry data is submitted to CMS January 4-March 31 after the close of the calendar year (e.g. PY2021 data is submitted Jan 4-March 31, 2022).
CMS web interface and claims-based date submission dates are different.
Phase 3: Performance FeedbackJuly of each year, the CMS provides performance feedback. Clinicians receive feedback before the start of the payment year.
Phase 4: Payment AdjustmentPayment adjustments are based on clinician performance two years prior to the calendar year (e.g. 2021 performance affects 2023 payment adjustment).

Pathologists Quality Registry

Optimize your performance in MIPS and enroll for the 2023 reporting period.

Learn more about the registry Right Arrow

We have a dedicated team to help you succeed in MIPS. Contact us to learn how we can optimize your MIPS performance.

Email: mips@cap.org

Phone: 800-323-4040, option 3