On December 27, 2020, the Consolidated Appropriations Act, 2021 was signed into law. Under this law, the Quality Payment Program’s Qualifying Alternative Payment Model (APM) Participant (QP) thresholds for payment years 2023 and 2024 are frozen at 50% for the payment amount threshold and 35% for the patient count threshold for performance years 2021 and 2022.

The partial QP thresholds have also been frozen at the same levels used for the 2022 payment year and 2020 performance year.

As a reminder, if you qualify as a QP, you may be eligible for the 5% APM incentive payment and be exempt from participating in MIPS.

How do I know if I am a QP in 2021?

CMS will use three snapshot dates—March 31, June 30, and August 31, 2021, to review data to make QP determinations. CMS will make determinations approximately 4 months after the end of each snapshot date, at which point you will be able to check the Quality Payment Program Participation Status Tool for updates to your APM status.

How do I know if I’m required to participate in MIPS in 2021?

If you are MIPS eligible and not determined to be a QP or a Partial QP, you will be required to participate in MIPS and will receive a MIPS Final Score and payment adjustment. To learn more about MIPS, visit qpp.cms.gov.

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Healthcentric Advisors
As the New England Quality Payment Program Support Center, Healthcentric Advisors assists New England-based physician and other eligible clinical practices to prepare for and participate in the new Quality Payment Program (QPP), established by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).