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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)
Reporting Requirements: Promoting Interoperability

February 27, 2024 / Resource

The promoting interoperability performance category of MIPS is intended to promote patient engagement and electronic exchange of information using certified electronic health record technology.
Reporting Requirements: Improvement Activities

February 27, 2024 / Resource

The improvement activities performance category of MIPS measures participation in activities that improve clinical practice.
Reporting Requirements: Quality

February 27, 2024 / Resource

The quality performance category of MIPS evaluates the quality of care you deliver by measuring health care processes, outcomes, and patient experiences of care.
Reporting Requirements: Cost

February 27, 2024 / Resource

The cost performance category is a measure of resource utilization based on Medicare claims for specific services that CMS has identified.
MIPS Value Pathways

February 27, 2024 / Resource

MIPS Value Pathways, or MVPs, are a voluntary reporting option that clinicians can participate in as an alternative to traditional MIPS or an APM Performance Pathway.
MIPS Scoring and Payment Adjustments

February 27, 2024 / Resource

MIPS Performance Reporting Requirements

February 27, 2024 / Resource

MIPS performance is measured across four categories – cost, quality, improvement activities, and promoting interoperability.
MIPS Participation and Reporting Options

February 27, 2024 / Resource

APTA provides details for the different MIPS participation and reporting options.
Mandatory Versus Voluntary Participation Options

February 27, 2024 / Resource

CMS has established a low-volume threshold to determine if an individual PT or a physical therapy private practice can be excluded from mandatory participation in MIPS.

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