Avoid penalties and earn bonuses for high quality patient care
If you treat Medicare Part B patients, you'll likely need to take part in the Quality Payment Program (QPP) to avoid penalties.
The Centers for Medicare and Medicaid Services (CMS) Quality Payment Program aims to improve health outcomes for Medicare patients by providing physician payment increases as a reward for high value, high quality care, while reducing payments for physicians who do not meet performance standards.
If you are a DO who provides medical services to patients that you bill for under the Medicare Physician Fee Schedule, you are likely subject to requirements of the Quality Payment Program. You can use your NPI number to learn whether you’re required to participate.
The QPP consists of two tracks:
Read on to learn how each track works and how the AOA can help your practice participate successfully.
Who’s exempt from the Quality Payment Program?
Physicians who are in their first year participating in Medicare; bill less than $30,000 in Medicare Part B charges yearly; or treat fewer than 100 Medicare patients per year are exempt from the Quality Payment Program. To learn whether you need to participate in MIPS, check the CMS MIPS Lookup Tool.
Applying for hardship exceptions
MIPS-eligible physicians who fall into these categories can apply for a hardship exemption from the Quality Payment Program:
- Spotty internet connectivity.
- Your practice doesn’t have certified electronic health record technology for reasons outside your control.
- Extreme and uncontrollable circumstances, such as a natural disaster in your area, bankruptcy, or the closure of your practice.