Are You Eligible for a 5-Percent Medicare Bonus Payment?

If you participate in MACRA's Advanced Alternative Payment Model (APM) program, you've been waiting all year for this.


Yes, but that's not what I was talking about specifically.

It's time to find out whether you're one of the coveted qualifying APM participants (QP) and therefore eligible for that sweet, sweet 5-percent lump-sum Medicare bonus payment in 2019.

The Centers for Medicare & Medicaid Services (CMS) has studied claims you submitted from Jan. 1 to March 31 and determined whether you have indeed achieved QP status for a year.

You want to know your status, don't you?

Good news. CMS has rolled out an interactive look-up tool that will let you know just where you stand. How about that? 

That Jan. 1 to March 31 time frame is one of three "snapshots" that CMS will use to determine QP eligibility. The others are Jan. 1 to June 30, and Jan. 1 to Aug. 31.

Information on the other two "snapshot" periods will be available soon, so check that tool periodically to see your status. You also should check with your advanced APM administrator for the next steps.

If you want to learn more about any of this, CMS offers a methodology fact sheet as well as a supplemental service payments fact sheet that will help get you up to speed.

You also can check out the QPP Resource Center provided by the Physicians Advocacy Institute (PAI) and Washington, D.C.-based consulting firm Healthsperien.

If you want TMA's help, and we've got a lot of great information from some of the state's leading experts, check out our MACRA Resource Center

Action, Oct. 17, 2017

Last Updated On

October 17, 2017