How to check if you're eligible for a Medicare alternative payment bonus

Physicians and other qualified health care professionals can now see whether they’re eligible for a 5% bonus and other rewards from Medicare’s alternative payment system. The Centers for Medicare & Medicaid Services (CMS) updated its Quality Payment Program (QPP) participation status tool last month with Alternative Payment Model (APM) data from Medicare Part B claims for services rendered between Jan. 1 and June 30, 2022.  

The tool includes 2022 Qualifying APM Participant (QP) status and Merit-based Incentive Payment System (MIPS) APM participation status. If you qualify as a QP, this means you are: 

• Eligible for the 5% APM incentive bonus, 
• Eligible for APM-specific rewards, and 
• Exempt from participating in MIPS. 

To view your QP or APM participation status: 

• Visit the QPP Participation Status Tool. 
• Enter your 10-digit National Provider Identifier (NPI). 

To learn more about how CMS determines QP and the APM participation status for each snapshot of data, please visit the QPP website. For more information on APMs, visit the QPP APM webpages. For a comprehensive list of APMs (PDF),  and additional materials, visit the QPP Resource Library. 

— Kent Moore, AAFP Senior Strategist for Physician Payment

Posted on Nov. 7, 2022