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A variety of programs have been developed to address value-based care payment, including the Medicare Quality Payment Program (QPP).

Certain PTs in private practice will be required to participate in the QPP program through either the Merit-Based Payment System (MIPS) OR Advanced Alternate Payment Models (APMs) beginning January 2020. Additionally, CMS has proposed to allow certain other PTs and physical therapy practices to opt in to the program, enabling them to earn incentive payments and to prepare for participation in Advanced APMs.

Alternative Payment Models

CMS is moving toward payment based on quality rather than quantity. Alternative payment models are at the forefront.

 

Access APM Resources

Merit-Based Incentive Programs

Learn about the three types of participation options under the Merit-Based Incentive Program.

Access MIPS Resources

Additional QPP Content

APTA and CMS Webinar on Quality Payment Program, MIPS, and Advanced APMs

September 7, 2018 / Article

Recorded webinar - FREE and only offered to APTA members
Everything you need to know about the Quality Payment Program, Including MIPS

December 4, 2018 / Article

This course provides insights into the New Year based on moving to value-based payment. Recorded webinar. Free to members.
Coding and Billing Updates: The Move to Value-based Payment

May 30, 2020 / Article

Recorded webinar from live Q & A (December 4, 2018)
Your MIPS Status May Have Changed: Here's How to Find Out

November 30, 2022 / News

CMS has updated eligibility determinations based on the most recent reporting periods. Make sure you know where you stand.
MIPS Submission Period and Exemption Window Close March 31

March 22, 2022 / News

Get your data in by the end of the month, or consider applying for a waiver due to "extreme and uncontrollable circumstances."
Study: Time for Better Risk Adjustment in THA, TKA Bundled Care Models

May 25, 2021 / Review

Researchers put price tags on comorbidities associated with higher TJA costs and see risk adjustment as a way to counter 'cherry picking.'
Providers Get Another Chance at MIPS Reporting Relief

February 26, 2021 / News

CMS has reopened a window for an exceptions process that allows clinicians to reweight MIPS categories for the 2020 performance year.
APTA's Outcomes Registry Again Receives Key CMS Designation

January 19, 2021 / News

The APTA Physical Therapy Outcomes Registry has been approved as a qualified clinical data registry — an important benefit for PTs in MIPS.
MIPS Participation and Reporting Options

December 22, 2020 / Resource

APTA provides details for the different MIPS participation and reporting options.
Final MIPS Rule Contains Minimal Changes

December 8, 2020 / Review

Like the proposed version, the final rule from CMS keeps the Quality Payment Program mostly as-is.
CMS: Minimal Changes to MIPS, Advanced Alternative Payment Models for 2021

August 7, 2020 / Review

The Quality Payment Program would see mostly minor changes and some shifts to respond to COVID-19-related challenges.
MIPS Performance Scores Now Available

August 7, 2020 / News

CMS has released its MIPS scores for your 2019 performance, which could affect your payment in 2021.

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