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MIPS Alternative Payment Models (APMs)

Certain Alternative Payment Models (APMs) are considered MIPS APMs and their participants are eligible for certain scoring benefits under MIPS.

MIPS APMs are APMs that meet these criteria:

  • APM entities that participate in the APM under an agreement with CMS;
  • APM bases payment incentives on performance (either at the APM entity or eligible clinician level), on cost/utilization, and quality measures.

Performance Year

Select your performance year.

2024 MIPS APMs

MIPS APM participants may report the APM Performance Pathway (APP).

The APP is a MIPS reporting and scoring pathway for 

MIPS eligible clinicians
 who are also participants in MIPS APMs. The APP is designed to reduce reporting burden, create new scoring opportunities for participants in MIPS APMs, and encourage participation in APMs. Performance is measured across 3 areas - quality, improvement activities, and Promoting Interoperability.

Any APM Entity in a MIPS APM may report via the APP on behalf of their MIPS eligible clinicians. However, the 

final score
 earned by the Entity through the APP would be applied only to those MIPS eligible clinicians who appear on a MIPS APM’s Participation List or Affiliated Practitioner List on one or more snapshot dates. The final score applied to each individual MIPS eligible clinician would be the highest available final score for that clinician (
TIN
/
NPI
), or a 
virtual group
 score, if applicable.

MIPS reporting and scoring requirements are applicable to all MIPS eligible clinicians, including those reporting the APP. Individuals, groups, APM Entities, and Accountable Care Organizations (ACOs) may report the APP.

MIPS APM participation is determined through 4 snapshots between January 1 through December 31.

If you join a MIPS APM during that period, you:

  • Will be considered a participant in the MIPS APM, and
  • Will be eligible to report the APP

Note: ACOs participating in the Medicare Shared Savings Program are required to report the APP for purposes of assessing their quality performance for that program, but MIPS eligible clinicians participating in these ACOs also have the option of reporting outside the ACO, or at an individual or group level, for purposes of being scored under MIPS, like all other MIPS APM participants.

Extreme and Uncontrollable Circumstances

APM Entities in the following models are eligible to submit an extreme and uncontrollable circumstances exception application for all MIPS performance categories:

  • ACO Reach (formerly Global and Professional Direct Contracting Model)
  • Bundled Payments for Care Improvement Advanced (BPCI Advanced)
  • Comprehensive Care for Joint Replacement Model (CJR)
  • Enhancing Oncology Model (EOM)
  • Kidney Care Choices Model (KCC)
  • Maryland Total Cost of Care Model (MD TCOC)
  • Medicare Shared Saving Program 
  • Primary Care First Model (PCF) 
  • Value in Opioid Use Disorder Treatment Demonstration Program (ViT) 
  • Vermont All-Payer ACO Model

When you submit an application on behalf of an APM Entity, you are attesting that at least 75% of the MIPS eligible clinicians in the Entity qualify for reweighting in the Promoting Interoperability performance category.

Participation

You can receive further support through APM Learning Systems.

Join

  1. Learn about specific MIPS APMs and how to apply.
  2. Apply to a MIPS APM that fits your 
    practice
     and is currently accepting applications.

Current Participants

If you are an eligible clinician currently participating in a MIPS APM (list of APMs linked below), please contact your APM entity for participation specifics.

Download the 2023 and 2024 Comprehensive List of APMs.