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.
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 Participation||General Timeline and Action|
|Phase 1: Performance Measurement||Reporting 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 Data||Registry data is submitted to CMS January 4-March 31 after the close of the calendar year (e.g. PY2020 data is submitted Jan 4-March 31, 2021).|
CMS web interface and claims-based date submission dates are different.
|Phase 3: Performance Feedback||July of each year, the CMS provides performance feedback. Clinicians receive feedback before the start of the payment year.|
|Phase 4: Payment Adjustment||Payment adjustments are based on clinician performance two years prior to the calendar year (e.g. 2020 performance affects 2022 payment adjustment).|
We have a dedicated team to help you navigate to MIPS reporting success.
Phone: 800-323-4040, option 3