Medicare QPP

Physicians Advocacy Institute

These resources have not been updated since 2023 but the general details remain relevant. For a summary of the key changes for CY 2024, please click here.

Frequently Asked Questions Updated for 2023

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2. Are eligible clinicians in MIPS APMs eligible for the exceptional performance bonus? Are they compared to other MIPS APMs or are they compared to all MIPS eligible clinicians?

  1. Does participating in MIPS APMs make it more likely that those clinicians will do well under MIPS compared with those not in a MIPS APM?

    Eligible clinicians in MIPS APMs are eligible for the exceptional performance bonus and are compared to all MIPS eligible clinicians. Participating in a MIPS APM does not necessarily mean a clinician will do better than if they participate in MIPS on their own because MIPS APM scores are determined at the aggregate APM entity level, so the performance of others in the group will impact your overall performance score for MIPS. Thus, it may be beneficial to participate in a MIPS APM when other also perform well, which could increase your overall score, but on the other hand, it may be harmful if others in the APM entity decrease your overall performance score. For more information on participating in a MIPS APM, please see this resource.



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