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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3. My CEHRT vendor said I have to submit all MIPS data through its product and pay additional fees to submit data for each MIPS category too. Is this true?

  1. No, various submission options are available to choose from for each MIPS category. Costs associated with submission via your CEHRT vendor can vary so it is important to ensure you are aware of all costs associated, and that the submission is both complete and accurate.

    The following reporting mechanisms are available for each of the MIPS performance categories.

    Medicare Part B claims

    • Quality measures are reported through routine billing processes
    • Only available to small practices (15 or fewer ECs)

    Direct

    • Third-party intermediaries transmit data through a computer-to-computer interaction (e.g., an API)
    • Third-party intermediaries include qualified clinical data registries (QCDRs), qualified registries, and EHR vendors

    CMS Web Interface

    • Web-based application with a required set of measures
    • Only available for Medicare Shared Savings Program Accountable Care Organizations (MSSP ACOs)

    Log-in and Attest

    • Participants can log-in and manually attest to data submission
    • Available to individual physicians and those in groups, as well as third-party intermediaries

    Log-in and Upload

    • Participants can login and upload data in an approved format on qpp.cms.gov
    • Available to individual physicians and those in groups, as well as third-party intermediaries
    The costs and considerations for each of these vary. For a list of pros and cons and other considerations, please see PAI’s Reporting Mechanisms Overview



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