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Quality Payment Program Reporting Basics

Avoid Medicare payment penalties through basic reporting.
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One Patient, One Measure, No Penalty

This is the first year physicians will need to report on quality measures under the new Quality Payment Program (QPP) from the Centers for Medicare and Medicaid Services (CMS). You can pick your pace of reporting for 2017 under the Merit-based Incentive Payment System (MIPS) of the QPP.

View this video to learn how to avoid a negative 4% payment adjustment in 2019 by reporting on one measure for one patient via CMS’ claim form before the end of 2017.

Pick Your Pace - Quality Payment Program

Use the step-by-step guide to supplement the video.

The step-by-step guide provides additional details.
See an example of a completed 1500 form.

Quality Measure Tools

  • Use CMS’ Quality Measure Search tool to find a relevant measure to report on and make note of its 3-digit quality ID number.
  • The ID number can be used to find the measure specifications document within the zip file from CMS’ Quality Measure Specifications page.
  • After downloading the zip file to your computer, find a folder called “QPP_Quality_measure_specifications” to access documents corresponding to individual measure specifications. Find and open the claim measure specification, not the registry measure specification.

First Check MIPS Eligibility

Several exemptions exist. Enter a national provider identifier (NPI) into CMS’ tool to determine if you should participate in MIPS in 2017. Exemptions include those for physicians with less than $30,000 in Medicare payments or fewer than 100 Medicare patients, who are new to Medicare in 2017, who participate in advanced alternative payment models, etc. 

In the case of hardship, such as insufficient internet connectivity, extreme and uncontrollable circumstances, or lack of control over the availability of Certified EHR Technology, some MIPS-eligible clinicians can use the advancing care information hardship exception application for 2017.

What to Do Next for QPP

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