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Resource Library

General Resources

2019 MIPS Quick Start Guide(pdf 1MB)MIPS Participation & Overview Fact Sheet(pdf 631KB)2018 QPP Access User Guide(zip 7.2MB)

Regulatory Resources

2019 QPP Final Rule(pdf 10MB)2019 QPP Final Rule Executive Summary(pdf 401KB)2019 QPP Final Rule Overview Factsheet(pdf 778KB)

Full Resource Library

<229>Resources
  • 2019 Medicare Shared Savings Program and QPP Interactions
    Created 01/18/2019
    PDF 473KB
      |  
    PY 2019
      |  
    Both
      |  
    Overview
      |  
    Technical Guides and User Guides
    Provides an overview of the interactions between the Medicare Shared Savings Program (SSP) and the Quality Payment Program (QPP) during the 2019 performance period.
  • Connect to an Organization: APM Entity
    Created 01/18/2019
    PY 2018
      |  
    APMs
      |  
    Overview
      |  
    Videos
    This video reviews how to request access (“connect”) to an Alternative Payment Model (APM) Entity so you can view, submit and manage data on behalf of the APM.
  • Connect to an Organization: Registry
    Created 01/18/2019
    PY 2018
      |  
    Both
      |  
    Overview
      |  
    Videos
    This video reviews how to request access (“connect”) to a Qualified Registry or Qualified Clinical Data Registry (QCDR) so you can submit data on behalf of your customers.
  • Connect to an Organization: Practice
    Created 01/18/2019
    PY 2018
      |  
    Both
      |  
    Overview
      |  
    Videos
    This video reviews how to request access (“connect”) to a practice so you can view, submit and manage data on behalf of the practice.
  • Connect to an Organization: Virtual Group
    Created 01/18/2019
    PY 2018
      |  
    Both
      |  
    Overview
      |  
    Videos
    This video reviews how to request access (“connect”) to a virtual group so you can view, submit and manage data on behalf of the virtual group.
  • Security Officials: Approving Role Requests
    Created 01/18/2019
    PY 2018
      |  
    Both
      |  
    Overview
      |  
    Videos
    This video shows how a security official can approve and deny requests from staff users.
  • Create a Quality Payment Program (QPP) Account
    Created 01/18/2019
    PY 2018
      |  
    Both
      |  
    Overview
      |  
    Videos
    This video reviews how to register for and create a new HARP account.
  • 2018 CMS Web Interface Excel Template
    Updated 01/17/2019
    XLSX 5MB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    Preformatted Excel Template used by the CMS Web Interface to input submission data.
  • 2018 CMS Web Interface Excel Template with Sample Data
    Updated 01/17/2019
    XLSX 3MB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    Provides an example of the latest CMS Web Interface Beneficiary Excel Template populated with sample data that allows users to understand the 2018 performance year changes prior to the testing and submission periods.
  • 2018 Qualified Registries Qualified Posting
    Updated 01/14/2019
    XLSX 125KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    Provides a list of 2018 Qualified Registries for the Merit-based Incentive Payment System (MIPS).
  • 2019 Qualified Clinical Data Registries (QCDRs) Qualified Posting
    Updated 01/14/2019
    XLSX 168KB
      |  
    PY 2019
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    Provides a list of the 2019 Qualified Clinical Data Registries (QCDRs) for the Merit-based Incentive Payment System (MIPS).
  • 2018 Qualified Clinical Data Registries (QCDRs) Qualified Posting
    Updated 01/14/2019
    XLSX 1MB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    Provides a list of 2018 Qualified Clinical Data Registries (QCDRs) for the Merit-based Incentive Payment System (MIPS).
  • 2018 Registration Guide for the CMS Web Interface and CAHPS for MIPS Survey
    Updated 01/10/2019
    PDF 1MB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    Registration guide for those who want to submit quality measures through the CMS Web Interface in 2018.
  • 2018 MIPS Data Validation Execution Report (DVER) Template
    Created 01/09/2019
    ZIP 30KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    Template for Qualified Clinical Data Registries (QCDRs) and Qualified Registries to use as guidance when submitting their Data Validation Execution Report (DVER).
  • 2018 CMS Web Interface Data Dictionary
    Updated 01/08/2019
    PDF 564KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    Lists elements from the CMS Web Interface Excel Template to assist users as they prepare to report data using the 2018 CMS Web Interface Excel Template.
  • 2018 CMS Web Interface User Guide
    Created 01/07/2019
    PDF 6MB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    This user guide shows you how to access the CMS Web Interface, report data, view quality data reporting progress, and how to get help using the using the CMS Web Interface.
  • 2019 QPP Final Rule - Updates for QCDRs and Registries
    Created 01/04/2019
    PDF 472KB
      |  
    PY 2019
      |  
    MIPS
      |  
    Quality
      |  
    Fact Sheets
    Provides summary of changes which may impact Qualified Clinical Data Registries (QCDRs) or Qualified Registries during the 2019 and/or 2020 MIPS performance periods.
  • 2018 CMS Web Interface FAQs
    Updated 01/04/2019
    PDF 819KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Fact Sheets
    This document will help answer frequently asked questions about data submission via the CMS Web Interface.
  • 2019 QPP Final Rule Overview Factsheet
    Updated 01/04/2019
    PDF 845KB
      |  
    PY 2019
      |  
    Both
      |  
    Overview
      |  
    Fact Sheets
    This factsheet provides a high-level overview of the Quality Payment Program final policies for the 2019 performance year.
  • 2018 Data Submission FAQs
    Created 01/03/2019
    PDF 446KB
      |  
    PY 2018
      |  
    Both
      |  
    Overview
      |  
    Fact Sheets
    Factsheet providing commonly asked questions about data submission for the 2018 performance year.
  • 2019 List of Medicare Health Plan Other Payer APMs
    Created 01/03/2019
    PDF 422KB
      |  
    PY 2019
      |  
    APMs
      |  
    Overview
      |  
    Fact Sheets
    This document specifically outlines payment arrangements by Medicare Health Plans that qualify as “other-payer” Advanced Alternative Payment Models (APMs) for 2019.
  • 2018 Eligible Measures Applicability (EMA) Resources
    Updated 01/02/2019
    ZIP 1MB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    Provides an overview of the EMA process and lists individual quality measures for both registry and claims data submission
  • 2018 Quality Benchmarks
    Updated 01/02/2019
    ZIP 544KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Measure Specifications and Benchmarks
    Lists and explains 2018 benchmarks used to assess performance in the Quality performance category.
  • 2019 MIPS Participation and Eligibility Fact Sheet
    Updated 12/31/2018
    PDF 739KB
      |  
    PY 2019
      |  
    MIPS
      |  
    Overview
      |  
    Fact Sheets
    Provides an overview of the eligibility criteria for participating in the Merit-based Incentive Payment System (MIPS) in 2019.
  • 2019 PI Information Blocking Factsheet
    Updated 12/31/2018
    PDF 583KB
      |  
    PY 2019
      |  
    MIPS
      |  
    Promoting Interoperability
      |  
    Fact Sheets
    Describes requirements for MIPS eligible clinicians to prevent actions that block the exchange of health information.
  • 2018 MIPS Scoring At-A-Glance
    Updated 12/28/2018
    PDF 2MB
      |  
    PY 2018
      |  
    MIPS
      |  
    Overview
      |  
    Technical Guides and User Guides
    Condensed overview of how CMS calculates scores for the 2018 performance year of the Merit-based Incentive Payment System (MIPS).
  • 2019 Cost Measure Code Lists
    Updated 12/27/2018
    ZIP 1MB
      |  
    PY 2019
      |  
    MIPS
      |  
    Cost
      |  
    Measure Specifications and Benchmarks
    Details the cost measure code lists for each of the 8 episode-based cost measures that are new for the Cost performance category in 2019.
  • 2019 Promoting Interoperability Measure Specifications
    Updated 12/27/2018
    ZIP 1MB
      |  
    PY 2019
      |  
    MIPS
      |  
    Promoting Interoperability
      |  
    Measure Specifications and Benchmarks
    Provides a detailed overview of the requirements for the 2019 Promoting Interoperability performance category objectives and measures.
  • 2019 Quality Measure Benchmarks
    Updated 12/27/2018
    ZIP 397KB
      |  
    PY 2019
      |  
    MIPS
      |  
    Quality
      |  
    Measure Specifications and Benchmarks
    Lists and explains 2019 benchmarks used to assess performance in the Quality performance category.
  • 2019 Cross-Cutting Quality Measures
    Updated 12/27/2018
    PDF 261KB
      |  
    PY 2019
      |  
    MIPS
      |  
    Quality
      |  
    Measure Specifications and Benchmarks
    Provides a list of the 2019 cross-cutting quality measures that are broadly applicable to all clinicians regardless of their specialty.
  • 2019 CMS Web Interface Measure Specifications and Supporting Documents
    Updated 12/27/2018
    ZIP 9MB
      |  
    PY 2019
      |  
    MIPS
      |  
    Quality
      |  
    Measure Specifications and Benchmarks
    Provides comprehensive descriptions of the 2019 CMS Web Interface measures for the Merit-based Incentive Payment System (MIPS) Quality performance category.
  • 2019 Clinical Quality Measure Specifications and Supporting Documents
    Updated 12/27/2018
    ZIP 76MB
      |  
    PY 2019
      |  
    MIPS
      |  
    Quality
      |  
    Measure Specifications and Benchmarks
    Provides comprehensive descriptions of the 2019 clinical quality measures for the Merit-based Incentive Payment System (MIPS) Quality performance category.
  • 2019 Medicare Part B Claims Measure Specifications and Supporting Documents
    Updated 12/27/2018
    ZIP 21MB
      |  
    PY 2019
      |  
    MIPS
      |  
    Quality
      |  
    Measure Specifications and Benchmarks
    Provides comprehensive descriptions of the 2019 claims measures for the Merit-based Incentive Payment System (MIPS) Quality performance category.
  • 2018 CMS Web Interface: Planning Your Work
    Created 12/27/2018
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Videos
    Explains the ways in which you can view and sort your beneficiary sample, clinic data, and providers in the CMS Web Interface.
  • 2018 CMS Web Interface: Manually Enter Data by Beneficiary
    Created 12/27/2018
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Videos
    Provides step-by-step instructions on the various ways that you can enter data manually by beneficiary in the CMS Web Interface.
  • 2018 CMS Web Interface: Manually Enter Data by Measure
    Created 12/27/2018
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Videos
    Provides step-by-step instructions on the various ways that you can enter data manually by measure in the CMS Web Interface.
  • 2018 CMS Web Interface: Excel User Video
    Created 12/27/2018
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Videos
    Explains how to download your beneficiary sample spreadsheet from the CMS Web Interface, as well as fundamental Excel template features, built-in prompts, and tips.
  • 2018 CMS Web Interface: View Progress
    Created 12/27/2018
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Videos
    Indicates where in the CMS Web Interface users can track their reporting progress, such as how many days are left until the submission is due and the number of measures that have met the minimum reporting requirement.
  • 2018 CMS Web Interface: Resolving errors
    Created 12/27/2018
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Videos
    Provides the workflow for identifying and resolving errors in your beneficiary data via the CMS Web Interface, the Excel upload, or Application Program Interface (API).
  • 2018 CMS Web Interface: Data Irregularities
    Created 12/27/2018
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Videos
    Provides the workflow for locating and correcting irregular and/or inconsistent data at both the measure and beneficiary levels.
  • 2019 Quality Performance Category Fact Sheet
    Updated 12/27/2018
    PDF 1MB
      |  
    PY 2019
      |  
    MIPS
      |  
    Quality
      |  
    Fact Sheets
    Discusses the Merit-based Incentive Payment System (MIPS) Quality performance category and includes an overview of quality measures and how to collect and submit quality data.
  • 2019 MIPS Summary of Cost Measures
    Updated 12/27/2018
    PDF 870KB
      |  
    PY 2019
      |  
    MIPS
      |  
    Cost
      |  
    Technical Guides and User Guides
    Provides a summary of cost measures in relation to the Merit-based Incentive Payment System (MIPS).
  • 2018 CMS Web Interface: PREV-10
    Created 12/27/2018
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Videos
    Explains the three populations in PREV-10, how these populations factor into a beneficiary’s performance rate, and how you report data in this measure.
  • 2019 Cost Performance Category Fact Sheet
    Updated 12/27/2018
    PDF 1MB
      |  
    PY 2019
      |  
    MIPS
      |  
    Cost
      |  
    Fact Sheets
    Discusses the Merit-based Incentive Payment System (MIPS) Cost performance category and provides details on the Total Per Capita Costs for All Attributed Beneficiaries measure (TPCC) and the Medicare Spending Per Beneficiary measure (MSPB), as well as the eight new episode-based measures.
  • 2019 Qualified Registries Qualified Posting
    Updated 12/27/2018
    XLSX 154KB
      |  
    PY 2019
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    Provides a list of the 2019 Qualified Registries for the Merit-based Incentive Payment System (MIPS).
  • 2018 CMS Web Interface: An introduction to the CMS Web Interface
    Created 12/27/2018
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Videos
    Provides an overview of using the CMS Web Interface and briefly goes over recent changes made to the user interface.
  • 2019 Improvement Activities Inventory
    Updated 12/27/2018
    ZIP 497KB
      |  
    PY 2019
      |  
    MIPS
      |  
    Improvement Activities
      |  
    Measure Specifications and Benchmarks
    Provides a complete list of the 2019 improvement activities and includes descriptions for each.
  • 2018 CMS Web Interface: Submission Due
    Created 12/27/2018
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Videos
    Details how your data is saved during the submission period and how you can access your final submission data via the Data Confirmation Report for a receipt of your final submission.
  • 2019 Cost Measure Information Forms
    Updated 12/27/2018
    ZIP 9MB
      |  
    PY 2019
      |  
    MIPS
      |  
    Cost
      |  
    Measure Specifications and Benchmarks
    Details the measure methodology for each of the 8 episode-based cost measures that are new for the Cost performance category in 2019 and provides an overview of the 2019 TPCC and MSPB cost measures that were established for the Merit-based Incentive Payment System (MIPS) in 2018.
  • 2018 CMS Web Interface: Test Your Data
    Created 12/27/2018
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Videos
    Explains how you can test your submission data before the reporting period, during the testing period. It also shows how you can view, download, and print reports.
  • 2018 QPP Access User Guide
    Updated 12/20/2018
    ZIP 7MB
      |  
    PY 2018
      |  
    Both
      |  
    Overview
      |  
    Technical Guides and User Guides
    The resources in this zip file will guide users through the process of obtaining a user ID and password, connecting to an organization, and managing their access to view, submit, and update their Quality Payment Program (QPP) data.
  • 2018 MIPS 101 Guide
    Updated 12/17/2018
    PDF 1MB
      |  
    PY 2018
      |  
    MIPS
      |  
    Overview
      |  
    Technical Guides and User Guides
    Guide provides a detailed overview of the Merit-based Incentive Payment System (MIPS) for 2018.
  • 2018 CMS Web Interface Excel Template User Guide
    Created 12/10/2018
    PDF 4MB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    This guide provides details about how to use the Excel template to submit MIPS data through the CMS Web Interface for the 2018 performance year.
  • 2018 Quality 101 Guide
    Created 11/21/2018
    PDF 1MB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    Guide detailing how to participate in the Quality performance category of MIPS in 2018.
  • 2018 MIPS Extreme and Uncontrollable Circumstances Policy
    Created 11/21/2018
    PDF 469KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Overview
      |  
    Fact Sheets
    Document detailing how to proceed with MIPS participation if clinicians were affected by natural disasters in 2018.
  • 2018 Promoting Interoperability 101 Guide
    Created 11/21/2018
    PDF 1MB
      |  
    PY 2018
      |  
    MIPS
      |  
    Promoting Interoperability
      |  
    Technical Guides and User Guides
    Guide detailing how to participate in the Promoting Interoperability performance category of MIPS in 2018.
  • 2018 CMS Web Interface Excel to XML Mapping
    Created 11/15/2018
    XLSX 18KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    Provides a mapping of the 2018 CMS Web Interface Excel Template fields to the 2016 GPRO Web Interface XML specifications.
  • 2018 PI Information Blocking Factsheet
    Created 11/15/2018
    PDF 584KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Promoting Interoperability
      |  
    Fact Sheets
    Describes requirements for MIPS eligible clinicians to prevent actions that block the exchange of health information.
  • 2017 QPP Performance Data Infographic
    Created 11/08/2018
    PDF 748KB
      |  
    PY 2017
      |  
    Both
      |  
    Overview
      |  
    Fact Sheets
    Visual aid showing 2017 performance data for the Quality Payment Program.
  • 2018 QPP Final Rule Executive Summary
    Created 11/07/2018
    PDF 203KB
      |  
    PY 2018
      |  
    Both
      |  
    Overview
      |  
    Fact Sheets
    This is the executive summary in the 2018 Quality Payment Program final rule with comment and interim final rule with comment, which made payment and policy changes to the Quality Payment Program starting January 1, 2018,
  • 2018 QPP Final Rule Overview Factsheet
    Created 11/07/2018
    PDF 621KB
      |  
    PY 2018
      |  
    Both
      |  
    Overview
      |  
    Fact Sheets
    This factsheet provides a high-level overview of the Quality Payment Program final policies for the 2018 performance period.
  • 2018 CMS Web Interface Support Webinars
    Created 11/07/2018
    PDF 194KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Fact Sheets
    Lists a series of webinars for Accountable Care Organizations (ACOs) and groups that are submitting data via the CMS Web Interface for the 2018 performance period.
  • 2018 Improvement Activities 101 Guide
    Created 11/05/2018
    PDF 3MB
      |  
    PY 2018
      |  
    MIPS
      |  
    Improvement Activities
      |  
    Technical Guides and User Guides
    Guide detailing how to participate in the Improvement Activities performance category of MIPS in 2018.
  • 2018 Cost 101 Guide
    Created 11/05/2018
    PDF 1MB
      |  
    PY 2018
      |  
    MIPS
      |  
    Cost
      |  
    Technical Guides and User Guides
    Guide detailing how to participate in the Cost performance category of MIPS in 2018.
  • 2018 Measures and Activities for Podiatrists
    Created 11/05/2018
    PDF 728KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Overview
      |  
    Specialty Guides
    Highlights measures and activities for MIPS performance categories that apply to podiatrists in 2018.
  • 2018 QPP Participation Infographic
    Created 11/05/2018
    PDF 665KB
      |  
    PY 2018
      |  
    Both
      |  
    Overview
      |  
    Fact Sheets
    Visual aid showing how to participate in the Quality Payment Program (QPP) during 2018.
  • 2018 MIPS Measures and Activities for Pathologists
    Created 11/05/2018
    PDF 742KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Overview
      |  
    Specialty Guides
    Highlights measures and activities for MIPS performance categories that apply to pathologists in 2018.
  • 2018 Measures and Activities for Emergency Medicine Clinicians
    Created 11/05/2018
    PDF 760KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Overview
      |  
    Specialty Guides
    Highlights measures and activities for MIPS performance categories that apply to emergency medicine clinicians in 2018.
  • 2018 Measures and Activities for Optometrists
    Created 11/05/2018
    PDF 691KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Overview
      |  
    Specialty Guides
    Highlights measures and activities for MIPS performance categories that apply to optometrists in 2018.
  • 2019 QPP Final Rule Executive Summary
    Created 11/05/2018
    PDF 399KB
      |  
    PY 2019
      |  
    Both
      |  
    Overview
      |  
    Fact Sheets
    This is the executive summary in the 2019 Quality Payment Program final rule, which will make payment and policy changes to the Quality Payment Program starting January 1, 2019,
  • 2018 CMS Web Interface Sampling Methodology
    Created 11/05/2018
    PDF 521KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    This document explains the sampling methodology for the 15 clinical quality measures submitted via the Centers for Medicare &amp; Medicaid Services (CMS) Web Interface.
  • 2019 MIPS Payment Adjustment Remittance Advice FAQs
    Created 11/05/2018
    PDF 357KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Overview
      |  
    Fact Sheets
    Provides information on how MIPS payment adjustments will be applied to payments in calendar year (CY) 2019 based on clinicians’ 2017 MIPS final scores.
  • 2018 Measures and Activities for Orthopedists
    Created 11/05/2018
    PDF 705KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Overview
      |  
    Specialty Guides
    Highlights measures and activities for MIPS performance categories that apply to orthopedists in 2018.
  • 2018 MIPS Quality Measures Impacted by ICD-10 Updates
    Created 11/05/2018
    PDF 422KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Fact Sheets
    Lists the 2018 MIPS quality measures impacted by ICD-10 code updates effective October 1, 2018.
  • 2018 Measures and Activities for Primary Care Clinicians
    Created 11/05/2018
    PDF 751KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Overview
      |  
    Specialty Guides
    Highlights measures and activities for MIPS performance categories that apply to primary care clinicians in 2018.
  • 2018 Measures and Activities for Ophthalmologists
    Created 11/05/2018
    PDF 738KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Overview
      |  
    Specialty Guides
    Highlights measures and activities for MIPS performance categories that apply to ophthalmologists in 2018.
  • 2018 MIPS Data Submission Infographic
    Created 11/05/2018
    PDF 679KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Overview
      |  
    Fact Sheets
    Visual aid showing how to submit data for the 2018 performance period.
  • 2019 QPP Multi-Payer Other Payer Advanced APMs
    Created 11/02/2018
    PDF 426KB
      |  
    PY 2019
      |  
    APMs
      |  
    Overview
      |  
    Fact Sheets
    A list of payment arrangements with CMS Multi-Payer Alternative Payment Models (APMs) that CMS has determined to be Other Payer Advanced APMs for Qualifying Participants (QPs) during the 2019 performance period
  • 2019 MIPS Quick Start Guide
    Created 11/01/2018
    PDF 1MB
      |  
    PY 2019
      |  
    MIPS
      |  
    Overview
      |  
    Technical Guides and User Guides
    A guide to help clinicians get started participating in the Merit-based Incentive Payment System (MIPS) during the 2019 performance year.
  • 2018 MIPS Scoring 101 Guide
    Created 10/28/2018
    PDF 4MB
      |  
    PY 2018
      |  
    MIPS
      |  
    Overview
      |  
    Technical Guides and User Guides
    Guide providing details about how scores are calculated for MIPS in the 2018 performance year.
  • 2018 CAHPS for MIPS Survey CMS Approved Survey Vendors
    Created 10/14/2018
    PDF 405KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    List of survey vendors approved by CMS to administer the 2018 CAHPS for MIPS Survey.
  • 2018 Group Participation in MIPS
    Created 10/14/2018
    PDF 11MB
      |  
    PY 2018
      |  
    MIPS
      |  
    Overview
      |  
    Fact Sheets
    Outlines group participation requirements in Year 2 of QPP.
  • 2018 Quality Performance Category Fact Sheet
    Created 10/14/2018
    PDF 956KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Fact Sheets
    Overview of the Quality performance category in the 2018 performance period.
  • 2019 MIPS Payment Adjustment Fact Sheet
    Created 10/14/2018
    PDF 525KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Overview
      |  
    Fact Sheets
    Fact sheet providing a general overview of 2019 payment adjustments based on Merit-based Incentive Payment System (MIPS) final scores for the 2017 performance year.
  • 2018 CMS Web Interface Measures and Supporting Documents
    Created 10/14/2018
    ZIP 8MB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Measure Specifications and Benchmarks
    Provides information on the measures necessary to submit data through the CMS Web Interface in 2018.
  • 2019 Medicaid Other Payer Advanced APMs in the Quality Payment Program
    Created 10/14/2018
    PDF 434KB
      |  
    PY 2019
      |  
    APMs
      |  
    Overview
      |  
    Fact Sheets
    Provides a list of Medicaid payment arrangements that CMS has determined to be Other Payer Advanced APMs for the Calendar Year (CY) 2019 QP Performance Period and discusses criteria that must be met.
  • 2018 MIPS Measures and Activities for Anesthesiologists and Certified Nurse Anesthetists
    Created 10/14/2018
    PDF 1MB
      |  
    PY 2018
      |  
    MIPS
      |  
    Overview
      |  
    Specialty Guides
    Highlights measures and activities for MIPS performance categories that apply to anesthesiologists and certified nurse anesthetists in 2018.
  • 2018 CMS QRDA III Schematrons, and Sample Files for Eligible Clinicians and Eligible Professionals
    Updated 10/14/2018
    ZIP 222KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
  • 2019 Payment Adjustment Infographic
    Created 10/14/2018
    PDF 238KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Overview
      |  
    Fact Sheets
    Snapshot of who will receive 2019 payment adjustments and how payment adjustments work.
  • 2018 Qualified Registry Self-Nomination fact sheet
    Created 10/01/2018
    PDF 457KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Fact Sheets
    Provides an overview of the self-nomination process and necessary requirements to self-nominate for qualified registries.
  • 2017 Targeted Review Fact Sheet
    Created 09/14/2018
    PDF 649KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Overview
      |  
    Fact Sheets
    Fact sheet providing an overview of the 2019 MIPS payment adjustment targeted review process.
  • 2017 Targeted Review User Guide
    Created 09/14/2018
    PDF 1MB
      |  
    PY 2017
      |  
    MIPS
      |  
    Overview
      |  
    Technical Guides and User Guides
    Guide is intended to help those who are requesting CMS to review their 2019 MIPS payment adjustment and lists steps to request a targeted review.
  • 2018 MIPS Data Validation Criteria
    Created 09/11/2018
    ZIP 15MB
      |  
    PY 2018
      |  
    MIPS
      |  
    Overview
      |  
    Technical Guides and User Guides
    Lists the 2018 criteria used to audit and validate data submitted in each performance category
  • 2018 CMS Web Interface & CAHPS for MIPS Survey Assignment Methodology
    Created 09/10/2018
    PDF 656KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Overview
      |  
    Technical Guides and User Guides
    Describes the process for assigning beneficiaries to a group or a virtual group participating in the Merit-based Incentive Payment System (MIPS) in 2018
  • 2018 MIPS Measures and Activities for Radiologists
    Created 09/06/2018
    PDF 1MB
      |  
    PY 2018
      |  
    MIPS
      |  
    Overview
      |  
    Specialty Guides
    Highlights measures and activities for MIPS performance categories that apply to radiologists in 2018
  • 2018 MIPS Measures and Activities for Cardiologists
    Created 09/05/2018
    PDF 1MB
      |  
    PY 2018
      |  
    MIPS
      |  
    Overview
      |  
    Specialty Guides
    Highlights measures and activities for MIPS performance categories that apply to cardiologists in 2018.
  • Submission Form for Eligible Clinician and APM Entity Requests for Other Payer Advanced Alternative Payment Model Determinations (Eligible Clinician Initiated Submission Form)
    Created 08/30/2018
    PDF 1MB
      |  
    PY 2018
      |  
    APMs
      |  
    Overview
      |  
    Technical Guides and User Guides
    Provides an overview of APM Entity or Eligible Clinician Initiated Other Payer Advanced APM Determination Proceeds(Eligible Clinician Initiation Process).
  • 2017 Quality Benchmarks
    Created 08/29/2018
    ZIP 1MB
      |  
    PY 2017
      |  
    MIPS
      |  
    Quality
      |  
    Measure Specifications and Benchmarks
    Zip file containing MIPS benchmark information for the Quality performance category.
  • 2017 Qualified Registries
    Created 08/27/2018
    PDF 1MB
      |  
    PY 2017
      |  
    Both
      |  
    Quality
      |  
    Technical Guides and User Guides
    List of qualified registries able to report data for the Quality, Advancing Care Information, and Improvement Activities performance categories on behalf of MIPS clinicians in 2017.
  • 2018 Claims Data Submission Fact Sheet
    Created 08/21/2018
    PDF 444KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Fact Sheets
    Details how to submit Quality data through claims in 2018
  • 2018 Cost Performance Category Fact Sheet
    Created 08/21/2018
    PDF 843KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Cost
      |  
    Fact Sheets
    Provides a broad overview of the 2018 Cost performance category.
  • 2019 Virtual Groups Toolkit
    Created 08/16/2018
    ZIP 1MB
      |  
    PY 2019
      |  
    MIPS
      |  
    Overview
      |  
    Technical Guides and User Guides
    Includes an agreement template, sample email, and a general overview of virtual groups and the election process
  • 2019 Self-Nomination Toolkit for QCDRs & Registries
    Created 08/14/2018
    ZIP 3MB
      |  
    PY 2019
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    Contains resources for QCDRs and Qualified registries to self-nominate for the 2019 performance year.
  • 2017 Performance Feedback User Guide
    Created 08/13/2018
    PDF 4MB
      |  
    PY 2017
      |  
    MIPS
      |  
    Overview
      |  
    Technical Guides and User Guides
    Guide addresses MIPS performance feedback as displayed on qpp.cms.gov and offers additional resources.
  • 2018 Exceptions FAQs
    Created 08/03/2018
    PDF 469KB
      |  
    PY 2018
      |  
    Both
      |  
    Overview
      |  
    Fact Sheets
    Lists questions and answers on topics relating to 2018 hardship exceptions
  • 2018 Predictive QP Methodology Fact Sheet
    Created 08/02/2018
    PDF 474KB
      |  
    PY 2018
      |  
    APMs
      |  
    Overview
      |  
    Fact Sheets
    Includes an overview of Predictive Qualifying Participant (QP) Status Analysis, Predictive QP and Partial QP determination steps, how eligible clinicians and beneficiaries were determined, and how thresholds were calculated.
  • 2018 Quality Measure Specifications Supporting Documents
    Created 07/31/2018
    ZIP 10MB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Measure Specifications and Benchmarks
    Provides guidance for the 2018 QPP individual measure specifications and measure flows for claims and registry submissions.
  • 2018 Other MIPS APM Quality Performance Category
    Created 07/27/2018
    PDF 543KB
      |  
    PY 2018
      |  
    Both
      |  
    Overview
      |  
    Fact Sheets
    Discusses the Other MIPS APM Quality Performance Category in Year 2 (2018) of the QPP.
  • 2018 CMS QRDA III Implementation Guide for Eligible Clinicians and Eligible Professionals
    Updated 07/27/2018
    PDF 5MB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
  • 2018 Cost Measures
    Created 07/27/2018
    ZIP 926KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Cost
      |  
    Measure Specifications and Benchmarks
    Provides overview of the 2018 TPCC and MSBP Cost measures calculation and methodology.
  • 2017 Enterprise Identity Data Management (EIDM) ACO User Guide
    Created 07/20/2018
    PDF 2MB
      |  
    PY 2017
      |  
    Both
      |  
    Overview
      |  
    Technical Guides and User Guides
    Guide describes EIDM roles for the ACO Security Official and the ACO&#039;s Web Interface Submitter only.
  • 2017 Enterprise Identity Data Management (EIDM) User Guide
    Created 07/20/2018
    PDF 2MB
      |  
    PY 2017
      |  
    Both
      |  
    Overview
      |  
    Technical Guides and User Guides
    Guide for users who need an EIDM account and/or Physician Quality and Value Program role to submit or access QPP data.
  • 2017 Performance Feedback Fact Sheet
    Created 07/13/2018
    PDF 515KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Overview
      |  
    Fact Sheets
    Fact sheet provides more information about receiving your MIPS performance feedback.
  • 2018 MIPS Bonus Overview Fact Sheet
    Created 07/11/2018
    PDF 778KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Overview
      |  
    Fact Sheets
    Outlines criteria providers must meet to receive a bonus payment in each performance category in 2018.
  • 2018 MIPS Participation and Overview Fact Sheet
    Created 07/11/2018
    PDF 630KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Overview
      |  
    Fact Sheets
    Provides a list of eligibility requirements to participate in 2018 MIPS, and a comparison of 2017 and 2018 final policies.
  • 2018 Promoting Interoperability Infographic
    Created 07/05/2018
    PDF 748KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Promoting Interoperability
      |  
    Fact Sheets
    Displays transition from ACI to PI and who the PI category now applies to.
  • 2018 Medicare Shared Savings Program & MIPS Interactions
    Created 07/03/2018
    PDF 430KB
      |  
    PY 2018
      |  
    Both
      |  
    Overview
      |  
    Fact Sheets
    Provides an overview of 2018 Medicare Shared Savings Program and MIPS Interactions in Year 2 (2018) of the QPP.
  • 2017 30-day All-Cause Hospital Readmission Measure
    Created 06/08/2018
    ZIP 512KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Quality
      |  
    Measure Specifications and Benchmarks
    30-day All-Cause Hospital Readmission measure specification sheet.
  • 2018 30-day All-Cause Hospital Readmission Measure Specifications
    Created 06/08/2018
    ZIP 433KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Measure Specifications and Benchmarks
    Provides details on measure development for the 30-Day All-Cause Hospital Readmission Measure
  • 2018 Promoting Interoperability Measure Specifications
    Created 06/06/2018
    ZIP 11MB
      |  
    PY 2018
      |  
    MIPS
      |  
    Promoting Interoperability
      |  
    Measure Specifications and Benchmarks
    Details 2018 PI measures, transition measures, and corresponding calculations
  • 2018 QCDR Measure Specifications
    Created 05/29/2018
    XLSX 694KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Measure Specifications and Benchmarks
    Details 2018 QCDR measures and corresponding calculations
  • 2018 Improvement Activities Performance Category Fact Sheet
    Created 05/24/2018
    PDF 571KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Improvement Activities
      |  
    Fact Sheets
    Provides an overview of the 2018 Improvement Activities performance category
  • 2018 Clinician Champions Program Nomination Form
    Created 05/22/2018
    PDF 1MB
      |  
    PY 2018
      |  
    Both
      |  
    Overview
      |  
    Fact Sheets
    Includes the nomination form to be considered for a clinician champion.
  • 2018 Clinician Champions Program Fact Sheet
    Created 05/22/2018
    PDF 321KB
      |  
    PY 2018
      |  
    Both
      |  
    Overview
      |  
    Fact Sheets
    Provides a list of criteria to become a clinician champion.
  • Submitting Medicare health plan requests for determinations
    Created 05/21/2018
    PDF 1MB
      |  
    PY 2018
      |  
    APMs
      |  
    Overview
      |  
    Specialty Guides
    Contains an overview on how Medicare Health Plans (inc. Medicare Advantage) make a request for Other Payer Advanced PM Determination for the QPP via the Health Plan Management System.
  • 2018 QCDR Self-Nomination fact sheet
    Created 05/11/2018
    PDF 361KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Fact Sheets
    Provides an overview of the self-nomination process, QCDRs, and necessary requirements to self-nominate.
  • 2018 Call for Measures & Activities
    Created 05/11/2018
    ZIP 4MB
      |  
    PY 2018
      |  
    MIPS
      |  
    Overview
      |  
    Measure Specifications and Benchmarks
    Provides detail and rationale for measure and activity development in QPP.
  • 2018 CAHPS for MIPS survey vendors FAQs
    Created 05/11/2018
    PDF 301KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    Provides FAQs for vendors for the CAHPS for MIPS Survey.
  • 2018 Quality Performance Category Scoring for Alternative Payment Models
    Created 05/11/2018
    PDF 1MB
      |  
    PY 2018
      |  
    APMs
      |  
    Quality
      |  
    Fact Sheets
    Provides an overview of scoring of the Quality performance category in MIPS APMs in Year 2 (2018) of the QPP.
  • 2018 Quality Performance Category Scoring Web Interface Reporters under the APM Scoring Standard
    Created 05/11/2018
    PDF 571KB
      |  
    PY 2018
      |  
    APMs
      |  
    Quality
      |  
    Fact Sheets
    Outlines MIPS Quality performance category scoring scenarios under the APM scoring standard.
  • 2018 Promoting Interoperability Performance Category Fact Sheet
    Created 05/11/2018
    PDF 944KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Promoting Interoperability
      |  
    Fact Sheets
    Provides an overview of the 2018 Promoting Interoperability performance category
  • 2018 Quality Payment Program All-Payer Combination Option & Other Payer Advanced Alternative Payment Models Frequently Asked Questions
    Created 05/11/2018
    PDF 888KB
      |  
    PY 2018
      |  
    APMs
      |  
    Overview
      |  
    Fact Sheets
    Provides an overview of Frequently Asked Questions (FAQs) surrounding All-Payer Combination Option and Other Payer Advanced APMs under QPP.
  • 2018 Improvement Activities
    Created 05/03/2018
    ZIP 1MB
      |  
    PY 2018
      |  
    MIPS
      |  
    Improvement Activities
      |  
    Fact Sheets
    Provides a list of the 2018 Improvement Activities.
  • 2018 Guide to Submitting CMS Multi-Payer Model Requests for Other Payer Advanced APM Determinations
    Created 04/30/2018
    PDF 1MB
      |  
    PY 2018
      |  
    APMs
      |  
    Overview
      |  
    Technical Guides and User Guides
    Includes an overview of submitting CMS Multi-Payer Model Requests for Other Advanced APM Determinations, including commercial payers
  • 2017 Improvement Activities Data Validation Criteria
    Created 04/16/2018
    PDF 364KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Improvement Activities
      |  
    Technical Guides and User Guides
    Document detailing the Improvement Activities performance category data validation criteria.
  • 2018 CMS Web Interface Fact Sheet
    Created 04/10/2018
    PDF 415KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Fact Sheets
    Provides an overview of CMS Web Interface in 2018
  • 2017 MIPS Improvement Activities Fact Sheet
    Created 04/06/2018
    PDF 109KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Improvement Activities
      |  
    Fact Sheets
    Fact sheet providing details on how to choose, submit, and report for the MIPS Improvement Activities performance category.
  • 2017 CAHPS for MIPS Survey Vendors
    Created 04/03/2018
    PDF 218KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    List of survey vendors approved to administer the CAHPS for MIPS survey for 2017.
  • 2017 MIPS Data Validation Criteria
    Created 04/03/2018
    ZIP 3MB
      |  
    PY 2017
      |  
    MIPS
      |  
    Overview
      |  
    Technical Guides and User Guides
    Zip file of MIPS data validation criteria.
  • 2018 CAHPS for MIPS Survey Overview Fact Sheet
    Created 03/27/2018
    PDF 633KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Fact Sheets
    Provides an overview of CAHPS for MIPS Survey in 2018
  • 2018 CAHPS for MIPS Survey – Sample Copy
    Created 03/27/2018
    PDF 665KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    Provides an example of a CAHPS for MIPS Survey in 2018
  • 2018 Scores for Improvement Activities in MIPS APMs
    Created 03/23/2018
    PDF 608KB
      |  
    PY 2018
      |  
    Both
      |  
    Improvement Activities
      |  
    Fact Sheets
    Provides an overview of scoring of IA in MIPS APMs in Year 2 (2018) of QPP.
  • 2018 All-Payer Combination Option glossary
    Created 03/22/2018
    PDF 382KB
      |  
    PY 2018
      |  
    APMs
      |  
    Overview
      |  
    Fact Sheets
    Contains definitions relevant to the All-Payer Combination Option.
  • 2017 MIPS Group Participation Guide
    Created 03/21/2018
    PDF 8MB
      |  
    PY 2017
      |  
    MIPS
      |  
    Overview
      |  
    Technical Guides and User Guides
    Guide detailing how to participate in MIPS as a group in 2017.
  • 2017 Quality Measure Specifications Supporting Documents
    Created 03/02/2018
    ZIP 10MB
      |  
    PY 2017
      |  
    MIPS
      |  
    Quality
      |  
    Measure Specifications and Benchmarks
    Quality measure specification supporting documents including claims registry information and webpage release notes.
  • 2018 CAHPS for MIPS survey vendors Application
    Created 02/27/2018
    PDF 1MB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    Provides a participation form/application for vendors for the CAHPS for MIPS Survey.
  • 2018 CAHPS for MIPS survey vendors Minimum Business Requirements
    Created 02/27/2018
    PDF 403KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    Provides information on the minimum business requirements for vendors for the CAHPS for MIPS Survey.
  • 2017 MIPS Claims-based Quality Measures Projections & Results
    Created 02/21/2018
    PY 2017
      |  
    MIPS
      |  
    Quality
      |  
    Videos
    Video demonstrating a new website feature that allows a user from a group who submits their Quality measures using the claims based submission method to log in and view their monthly calculation of those claim based measures.
  • 2018 Quality Measure Specifications
    Created 02/09/2018
    ZIP N/A
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Measure Specifications and Benchmarks
    Lists 2018 Claims Registry Measures
  • 2017 Claims Data Submission Fact Sheet
    Created 02/07/2018
    PDF 515KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Quality
      |  
    Fact Sheets
    Fact sheet detailing how to submit data through claims for the Quality performance category and gives billing staff helpful data collection and submission tips.
  • 2017 Advancing Care Information Performance Category Fact Sheet
    Created 02/06/2018
    PDF 554KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Advancing Care Information
      |  
    Fact Sheets
    Fact sheet detailing specific information on the Advancing Care Information performance category.
  • 2017 Comprehensive List of APMs
    Created 02/05/2018
    PDF 351KB
      |  
    PY 2017
      |  
    APMs
      |  
    Overview
      |  
    Technical Guides and User Guides
    List displaying the APMs that CMS operates.
  • 2018 Comprehensive List of APMs
    Created 02/05/2018
    PDF 459KB
      |  
    PY 2018
      |  
    APMs
      |  
    Overview
      |  
    Fact Sheets
    Includes a list of the different types of APMs and Advanced APM determinations based on final criteria.
  • 2017 Extreme and Uncontrollable Circumstances Policy for MIPS Fact Sheet
    Created 02/02/2018
    PDF 479KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Overview
      |  
    Fact Sheets
    Document detailing how to proceed with MIPS participation if clinicians were affected by natural disasters in 2017.
  • 2018 Guide to Submitting Medicaid Requests for Other Payer Advanced APM Determinations (Payer Initiated Submission Form)
    Created 02/01/2018
    PDF 902KB
      |  
    PY 2018
      |  
    APMs
      |  
    Overview
      |  
    Technical Guides and User Guides
    Provides an overview on submitting Medicaid requests for Other Payer Advanced APM Determinations and walks through the Payer Initiated Submission Form.
  • 2018 QPs Methodology Fact Sheet
    Created 02/01/2018
    PDF 2MB
      |  
    PY 2018
      |  
    APMs
      |  
    Overview
      |  
    Fact Sheets
    Provides an overview of the determination of Qualifying Participants (QPs) and Partial QPs, how CMS will identify eligible clinicians participating in Advanced APMs, and how to calculate payment amount threshold scores.
  • 2017 QPs Methodology Fact Sheet
    Created 02/01/2018
    PDF 377KB
      |  
    PY 2017
      |  
    APMs
      |  
    Overview
      |  
    Fact Sheets
    Fact sheet describes the process and methodology that CMS will use to identify eligible clinicians who, through their participation in APMs, are qualifying APM participating for a year and will be eligible to receive the 5% APM incentive payment.
  • 2018 CMS Quality Payment Program Guide for Managed Care Organizations Providing State Medicaid Agencies with Information and Documentation for Submitting Medicaid Requests for Other Payer Advanced APM Determinations
    Created 02/01/2018
    PDF 386KB
      |  
    PY 2018
      |  
    APMs
      |  
    Overview
      |  
    Technical Guides and User Guides
    Provides Managed Care Organizations (MCOs) an overview of the submission process (conducted by the States), and to outline information necessary for States to collect from MCOs.
  • 2017 CMS Web Interface Data Dictionary
    Created 01/29/2018
    PDF 510KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    A data dictionary for web interface excel templates.
  • 2017 CMS Web Interface User Guide
    Created 01/29/2018
    PDF 9MB
      |  
    PY 2017
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    Detailed instructions on how to use the CMS web interface.
  • 2017 CMS Web Interface Excel to XML Mapping
    Created 01/29/2018
    XLSX 19KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    Web interface excel to XML mapping.
  • 2017 MIPS 101 Scoring Guide
    Created 01/24/2018
    PDF 3MB
      |  
    PY 2017
      |  
    MIPS
      |  
    Overview
      |  
    Technical Guides and User Guides
    MIPS scoring guide for the 2017 performance period.
  • Advancing Care Information Measure Specifications
    Created 01/24/2018
    ZIP 13MB
      |  
    PY 2017
      |  
    MIPS
      |  
    Advancing Care Information
      |  
    Measure Specifications and Benchmarks
    2017 MIPS Advancing Care Information measures and transition measures specification sheets.
  • 2018 Patient Facing Encounter Codes
    Created 01/23/2018
    ZIP 238KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Measure Specifications and Benchmarks
    Lists the determinants used to assess the non-patient facing status of 2018 MIPS eligible clinicians
  • 2018 Other Payer Advanced APM Determination Process: Medicare Health Plans Fact Sheet
    Created 01/23/2018
    PDF 441KB
      |  
    PY 2018
      |  
    APMs
      |  
    Overview
      |  
    Fact Sheets
    Includes an overview of the All-Payer Combination Option and steps for submitting Medicare Health Plan payment arrangement information to CMS for Other Payer Advanced APM Determinations.
  • 2017 MIPS Advancing Care Information 101 Guide
    Created 01/17/2018
    PDF 4MB
      |  
    PY 2017
      |  
    MIPS
      |  
    Advancing Care Information
      |  
    Technical Guides and User Guides
    Guide detailing how to participate in the Advancing Care Information performance category of MIPS in 2017.
  • 2017 CMS Web Interface Excel Template (with change log)
    Created 01/12/2018
    XLSX 3MB
      |  
    PY 2017
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    Web interface excel template with change log included.
  • 2017 Participation in the EHR Incentive Programs vs. MIPS
    Created 01/12/2018
    PDF 501KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Overview
      |  
    Fact Sheets
    Fact sheet comparing the EHR Incentive Programs and MIPs with information on how to determine which program to participate in.
  • 2017 CMS Web Interface Excel Template User Guide
    Created 01/04/2018
    PDF 1MB
      |  
    PY 2017
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    Detailed instructions on how to use the CMS web interface excel templates.
  • 2017 Data Submission Fact Sheet
    Created 01/02/2018
    PDF 547KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Overview
      |  
    Fact Sheets
    Fact sheet detailing how to submit 2017 transition year data to the Quality Payment Program.
  • 2017 CMS Web Interface Excel Template (with sample data)
    Created 01/02/2018
    XLSX 5MB
      |  
    PY 2017
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    Web interface excel template with sample data included.
  • 2017 Advancing Care Information (ACI) Data Submission for APMs
    Created 01/02/2018
    PY 2017
      |  
    APMs
      |  
    Advancing Care Information
      |  
    Videos
    Walkthrough of how Advancing Care Information reporting is completed for APM entities using the user interface on qpp.cms.gov.
  • 2017 QCDRs and Qualified Registries Data Submission
    Created 01/02/2018
    PY 2017
      |  
    MIPS
      |  
    Quality
      |  
    Videos
    Demonstration of the product features that are available to Qualified Registries and QCDRs for submitting data on behalf of individual clinicians and or groups.
  • 2017 MIPS Data Submission
    Created 01/02/2018
    PY 2017
      |  
    MIPS
      |  
    Overview
      |  
    Videos
    Shows users who represent groups and/or individual clinicians how they can submit data for the Quality, Advancing Care Information, and Improvement Activities performance categories.
  • 2018 Other Payer Advanced APM Determination Process: CMS Multi-Payer Models
    Created 01/01/2018
    PDF 450KB
      |  
    PY 2018
      |  
    APMs
      |  
    Overview
      |  
    Fact Sheets
    Includes an overview of the CMS Multi-Payer Model and the All-Payer Combination Option, discusses Steps for submitting CMS Multi-Payer Model payment arrangement information to CMS for Other Payer Advanced APM Determinations.
  • 2017 Cost Measures
    Created 12/29/2017
    ZIP 751KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Cost
      |  
    Measure Specifications and Benchmarks
    Cost measure information forms for Medicare Spending per Beneficiary and Total per Capita Costs for all Attributed Beneficiaries.
  • 2017 CMS Web Interface Measures and Supporting Documents
    Created 12/20/2017
    ZIP 21MB
      |  
    PY 2017
      |  
    MIPS
      |  
    Quality
      |  
    Measure Specifications and Benchmarks
    Provides information on the measures necessary to submit data through the CMS Web Interface in 2017.
  • 2017 Quality Measure Specifications
    Created 12/20/2017
    ZIP N/A
      |  
    PY 2017
      |  
    MIPS
      |  
    Quality
      |  
    Measure Specifications and Benchmarks
    Quality claims &amp; registry measures.
  • 2017 Qualified Clinical Data Registries
    Created 12/19/2017
    PDF 4MB
      |  
    PY 2017
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    Guide listing the MIPS 2017 CMS-approved Qualified Clinical Data Registries.
  • 2017 APMs: Medicaid Models & All-Payer Models
    Created 12/14/2017
    PDF 670KB
      |  
    PY 2017
      |  
    APMs
      |  
    Overview
      |  
    Fact Sheets
    Fact sheet provides a brief overview of the CMS process for determining whether payment arrangements with payers other than Medicare meet the criteria for Other Pay Advanced APM under the All-Payer Combination Option.
  • 2017 Comprehensive Care for Joint Replacement Under QPP Fact Sheet
    Created 12/06/2017
    PDF 318KB
      |  
    PY 2017
      |  
    APMs
      |  
    Overview
      |  
    Fact Sheets
    Document explains how an attribution-eligible beneficiary is defined for the Advanced APM track of the Comprehensive Care for Joint Replacement Model solely for purposes of making QP determinations in the Quality Payment Program.
  • 2017 CMS Web Interface User Demonstration
    Created 11/29/2017
    PY 2017
      |  
    MIPS
      |  
    Quality
      |  
    Videos
    User demonstration video of the CMS Web Interface.
  • 2017 Excel Template Introduction
    Created 11/21/2017
    PY 2017
      |  
    MIPS
      |  
    Quality
      |  
    Videos
    User demonstration video of how to use the excel template to upload beneficiary samples to the CMS Web Interface.
  • 2017 MIPS Measures for Optometrists
    Created 11/17/2017
    PDF 756KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Overview
      |  
    Specialty Guides
    Provides a non-exhaustive sample of measures that may apply to optometrists.
  • 2017 MIPS Participation Infographic
    Created 11/16/2017
    PDF 337KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Overview
      |  
    Fact Sheets
    Infographic detailing how eligible clinicians can participate in MIPS in 2017.
  • 2017 All-Payer Combination Option & Other Payer Advanced APMs
    Created 11/16/2017
    PDF 1MB
      |  
    PY 2017
      |  
    APMs
      |  
    Overview
      |  
    Fact Sheets
    Fact sheet provides an overview of the final policies regarding the All-Payer Combination Option and Other Payer Advanced Alternative Payment Models.
  • 2017 CMS Web Interface Sampling Methodology
    Created 11/01/2017
    PDF 1MB
      |  
    PY 2017
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    Explains the sampling methodology for the 15 clinical quality measures reported via the CMS Web Interface.
  • 2017 MIPS Measures for Podiatrists
    Created 11/01/2017
    PDF 399KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Overview
      |  
    Specialty Guides
    Provides a non-exhaustive sample of measures that may apply to podiatrists.
  • 2017 CMS Web Interface & CAHPS for MIPS Survey Assignment Methodology
    Created 11/01/2017
    PDF 1MB
      |  
    PY 2017
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    Describes the process for assigning beneficiaries to groups participating in MIPS.
  • 2017 MIPS Measures for Radiologists
    Created 11/01/2017
    PDF 409KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Overview
      |  
    Specialty Guides
    Provides a non-exhaustive sample of measures that may apply to radiologists.
  • 2018 Virtual Groups Toolkit
    Created 11/01/2017
    ZIP 1MB
      |  
    PY 2018
      |  
    MIPS
      |  
    Overview
      |  
    Technical Guides and User Guides
    Zip file of Virtual Group Agreement Checklist, Agreement Template, Election Process Fact Sheet, Overview Fact Sheet.
  • 2017 MIPS 101 Guide
    Created 11/01/2017
    PDF 8MB
      |  
    PY 2017
      |  
    MIPS
      |  
    Overview
      |  
    Technical Guides and User Guides
    Guide provides a detailed overview and introduction for year 1 of MIPS.
  • 2017 Qualified Registry Fact Sheet
    Created 10/16/2017
    PDF 457KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Quality
      |  
    Fact Sheets
    Fact sheet detailing how to self-nominate and successfully qualify to become a qualified registry.
  • 2017 QCDR & Qualified Registries Self-Nomination User Guide
    Created 10/16/2017
    PDF 2MB
      |  
    PY 2017
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    Guide to help Qualified Registry and Qualified Clinical Data Registry vendors to self-nominate for MIPS.
  • 2017 QCDR Fact Sheet
    Created 10/16/2017
    PDF 673KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Quality
      |  
    Fact Sheets
    Fact sheet detailing how to self-nominate and successfully qualify to become a QCDR.
  • 2017 Episode-based Cost Measure Field Test Reports Fact Sheet
    Created 10/01/2017
    PDF 252KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Cost
      |  
    Fact Sheets
    Fact sheet providing detailed information on episode-based cost measures.
  • 2017 Medicare Shared Savings Program & MIPS Interactions
    Created 10/01/2017
    PDF 388KB
      |  
    PY 2017
      |  
    APMs
      |  
    Overview
      |  
    Fact Sheets
    Table detailing ACO MIPS performance category and eligibility status.
  • 2017 Quality Payment Program Key Objectives
    Created 10/01/2017
    PDF 592KB
      |  
    PY 2017
      |  
    Both
      |  
    Overview
      |  
    Fact Sheets
    Details the strategic objectives for the Quality Payment Program.
  • 2017 MIPS Advancing Care Information Blocking
    Created 10/01/2017
    PDF 769KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Advancing Care Information
      |  
    Fact Sheets
    Fact sheet detailing how to attest to the prevention of information blocking, under the PI performance category.
  • 2017 MIPS Measures for Anesthesiologists & Certified Registered Nurse Anesthetists
    Created 09/07/2017
    PDF 445KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Overview
      |  
    Specialty Guides
    Provides a non-exhaustive sample of measures that may apply to anesthesiologists and certified registered nurse anesthetists.
  • 2017 MIPS Measures for Orthopedists
    Created 09/07/2017
    PDF 498KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Overview
      |  
    Specialty Guides
    Provides a non-exhaustive sample of measures that may apply to orthopedists.
  • 2017 MIPS Measures for Ophthalmologists
    Created 09/07/2017
    PDF 341KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Overview
      |  
    Specialty Guides
    Provides a non-exhaustive sample of measures that may apply to ophthalmologists.
  • 2017 MIPS Measures for Emergency Medicine Clinicians
    Created 09/07/2017
    PDF 463KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Overview
      |  
    Specialty Guides
    Provides a non-exhaustive sample of measures that may apply to emergency medicine clinicians.
  • 2018 Merit-based Incentive Payment System (MIPS) Qualified Registry Self-Nomination Fact Sheet
    Created 09/01/2017
    PDF 621KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Fact Sheets
    Contains an overview of the self-nomination and qualification process to become a qualified registry for the QPP in Year 2.
  • 2017 Supplemental Service Payments for APMs Fact Sheet
    Created 09/01/2017
    PDF 295KB
      |  
    PY 2017
      |  
    APMs
      |  
    Overview
      |  
    Fact Sheets
    Fact sheet provides details pertaining to supplemental service payments and criteria required to receive these payments.
  • 2018 Self-Nomination Toolkit for QCDRs & Qualified Registries
    Created 09/01/2017
    ZIP 2MB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    Contains materials about the QCDR self-nomination process, including fact sheets, a user guide, and a measures submission template.
  • 2018 Self-Nomination QCDR Measure Submission Template
    Created 09/01/2017
    XLSX 38KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    Provides a template for self-nomination to submit measures as a way to become a QCDR registry.
  • 2017 Eligible Measures Applicability (EMA) Resources
    Created 09/01/2017
    ZIP 860KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    Provides an overview of the EMA process and lists individual quality measures for both registry and claims data submission.
  • 2018 Quality Payment Program (QPP): Self-Nomination User Guide for QCDRs & Qualified Registries
    Created 09/01/2017
    PDF 2MB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    Provides an in-depth overview of the self-nomination process for both QCDRs and qualified registries.
  • 2017 MIPS Quality Performance Category Fact Sheet
    Created 08/16/2017
    PDF 2MB
      |  
    PY 2017
      |  
    MIPS
      |  
    Quality
      |  
    Fact Sheets
    Fact sheet providing an overview of the Quality performance category.
  • 2017 Alternative Payment Model (APM) Design Toolkit
    Created 08/16/2017
    PDF 2MB
      |  
    PY 2017
      |  
    APMs
      |  
    Overview
      |  
    Technical Guides and User Guides
    A toolkit for any entities or individuals interested in developing APMS.
  • 2017 MIPS Quality Performance Category Scoring for MSSP & Next Generation ACOs
    Created 07/13/2017
    PDF 604KB
      |  
    PY 2017
      |  
    APMs
      |  
    Quality
      |  
    Fact Sheets
    Provides MIPS Quality performance category scoring scenarios, under the APM scoring standard, for groups submitting quality measure data via Web Interface and ACOs.
  • 2017 Quality Reporting Document Architecture (QRDA) III Implementation Guide
    Created 07/07/2017
    PDF 2MB
      |  
    PY 2017
      |  
    Both
      |  
    Quality
      |  
    Technical Guides and User Guides
    A QRDA III implementation guide for eligible clinicians.
  • 2017 MIPS Measures for Cardiologists
    Created 06/15/2017
    PDF 1MB
      |  
    PY 2017
      |  
    MIPS
      |  
    Overview
      |  
    Specialty Guides
    Provides a non-exhaustive sample of measures that may apply to cardiologists.
  • 2017 CMS Web Interface Fact Sheet
    Created 06/15/2017
    PDF 414KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Quality
      |  
    Fact Sheets
    Fact sheet providing an overview of how to submit MIPS data through the CMS Web Interface.
  • 2017 MIPS Measures for Primary Care Clinicians
    Created 06/15/2017
    PDF 1MB
      |  
    PY 2017
      |  
    MIPS
      |  
    Overview
      |  
    Specialty Guides
    Provides a non-exhaustive sample of measures that may apply to primary care clinicians.
  • 2017 Medicare Shared Savings Program & the Quality Payment Program
    Created 06/12/2017
    PDF 171KB
      |  
    PY 2017
      |  
    APMs
      |  
    Overview
      |  
    Fact Sheets
    Fact sheet detailing how the Quality Payment Program and Shared Savings Program work together.
  • 2017 Predictive QP Methodology Fact Sheet
    Created 06/02/2017
    PDF 1MB
      |  
    PY 2017
      |  
    APMs
      |  
    Overview
      |  
    Fact Sheets
    Fact sheet providing details on how predictive qualifying APM participant status was determined.
  • 2017 Quick Start Guide to the Merit-based Incentive Payment System (MIPS)
    Created 06/01/2017
    PDF 567KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Overview
      |  
    Technical Guides and User Guides
    Guide providing an overview of the Quality Payment Program including participation requirements and reporting periods.
  • 2017 CAHPS for MIPS Survey - Sample Copy
    Created 05/25/2017
    PDF 340KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Quality
      |  
    Fact Sheets
    Example of how to complete the CAHPS for MIPS Survey.
  • 2017 MIPS APMs in the Quality Payment Program
    Created 05/23/2017
    PDF 192KB
      |  
    PY 2017
      |  
    APMs
      |  
    Overview
      |  
    Fact Sheets
    Fact sheet providing general information about MIPS APMs, the scoring standard, performance period, and how the scoring standard is applied.
  • 2018 Merit-based Incentive Payment System (MIPS) Qualified Clinical Data Registry (QCDR) Self-Nomination Fact Sheet
    Created 05/11/2017
    PDF 673KB
      |  
    PY 2018
      |  
    MIPS
      |  
    Quality
      |  
    Fact Sheets
    Contains an overview of the self-nomination and qualification process to become a qualified clinical data registry (QCDR) for QPP in Year 2.
  • 2017 Technical Assistance Resource Guide
    Created 05/10/2017
    PDF 367KB
      |  
    PY 2017
      |  
    Both
      |  
    Overview
      |  
    Technical Guides and User Guides
    Guide providing technical assistance resources to help clinicians successfully participate in the Quality Payment Program.
  • 2017 MIPS Participation Fact Sheet
    Created 05/04/2017
    PDF 230KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Overview
      |  
    Fact Sheets
    Fact sheet outlining 2017 MIPS participation requirements.
  • 2017 CAHPS for MIPS Fact Sheet
    Created 03/31/2017
    PDF 221KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Quality
      |  
    Fact Sheets
    Overview of the CAHPS for MIPS Survey, including FAQs and requirements.
  • 2017 Support for Small Practices
    Created 03/17/2017
    PDF 193KB
      |  
    PY 2017
      |  
    Both
      |  
    Overview
      |  
    Fact Sheets
    Fact sheet providing technical assistance resources for small practices.
  • 2017 Patient Facing Encounter Codes
    Created 12/29/2016
    ZIP 310KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Quality
      |  
    Technical Guides and User Guides
    Zip file containing patient-facing encounter code information including a fact sheet and list.
  • 2017 Improvement Activities & APMs
    Created 12/29/2016
    PDF 387KB
      |  
    PY 2017
      |  
    APMs
      |  
    Improvement Activities
      |  
    Technical Guides and User Guides
    Document detailing the improvement activities performance category score CMS will assign participants in each MIPS APMs for the 2017 performance year.
  • 2017 Advancing Care Information for Vendors
    Created 12/29/2016
    PDF 83KB
      |  
    PY 2017
      |  
    MIPS
      |  
    Advancing Care Information
      |  
    Fact Sheets
    Fact sheet outlines the steps for EHR Vendors participating in the Quality Payment Program.

Related Content

Webinars

Looking for webinars? Visit Webinar Library to watch webinars or view the slides as a PDF.

Explore Measures

Looking for measure information? Visit our Explore Measures Tool.

eCQI Resource Center

Looking for resources to support Electronic Clinical Quality Improvement (eCQI)? Visit the eCQI Resource Center.

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