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Developer Tools

The Quality Payment Program (QPP) provides opportunities for developers to build software that integrates directly with CMS applications and data. This will be a long-term, iterative process in which developer participation and feedback will be essential.

There are two opportunities for developers to integrate their software with applications and data from CMS:

  • QPP Measures Data Repository - A complete list of Advancing Care Information (ACI), Improvement Activities (IA), and quality measures for QPP 2017 is available in the QPP Measures Data Repository. Note that this replaces the QPP Measurement API released in November 2016.
  • QPP APIs - Users of these APIs can submit data to CMS with XML or JSON (industry standards for data transmission) as well as perform functions related to the CMS Web Interface. They will deliver real-time, actionable feedback on the validity of your submission as well as a composite score based on information available at the time of submission.
    Composite scores provided at the time of submission reflect all measure categories (Advancing Care Information (ACI), Improvement Activities (IA), and quality) submitted to date. These scores do not represent a guarantee of the final score.

You can use both the QPP Measures Data Repository and the QPP Submissions APIs today. To learn more continue reading this page.

Explore the QPP Measures Data Repository

Explore the QPP Submissions API

What is an Application Programming Interface (API)?

An Application Programming Interface, or API, is a set of software instructions and standards that allows machine-to-machine communication. An organization can use an API to retrieve data and use it in their own tools. For example, if you see a real estate site using maps from an external site, the real estate site is using the external site’s API to show maps for the real estate company’s properties. Instead of creating the maps themselves or updating them manually, the real estate company is using the API to pull data directly from the external site.

QPP Measures Data Repository

Note that the QPP Measures Data Repository replaces the QPP Measurement API released in November 2016. Read the information below to learn about the enhanced functionality and what you need to do to start using it in place of the API.

What is the QPP Measures Data Repository?

The complete list of Advancing Care Information (ACI), Improvement Activities (IA), and quality measures for the QPP Transition Year (2017) is available in the qpp-measures-data repository. Each measure contains a description and additional information regarding attestation (reporting) and scoring requirements.

What Can I Do With This Repository?

You can integrate with the qpp-measures-data Node Package Manager (NPM) module to import measures data into your own codebase and work with it through direct software interaction.

Why Would I Use This Repository?

Previously, if you were building a site with a list of measures, you would need to add each measure to the site manually. When CMS updated the measures, the information on your site would become out of date, unless you manually updated it. Using this repository, you can set up your site so that it requests the measures you want to display, and when CMS makes updates to those measures, these changes can then automatically appear on your site (as long as you reference the latest version of the NPM module).

QPP APIs

What Can I Do with These APIs?

There will be two QPP APIs that developers can use to submit QPP performance data to CMS through direct software interaction, instead of manually:

  • Submissions API
    • Submit data as a single file or a set of smaller files throughout the reporting period, using QRDA-III or a new, streamlined QPP data format
    • Submit, update or delete ACI, IA and quality measures data during the reporting period
    • Receive feedback on the content and accuracy of a submission
    • Receive the preliminary score for a submission, based on the finalized policy
  • CMS Web Interface API
    • If you are registered for the CMS Web Interface, download your group’s beneficiary sample, modify it and submit it to the CMS Web Interface
    • Receive feedback on the content and accuracy of a submission
    • Receive a real-time composite score for a submission
Current submission process compared to submission process with an API

Who Can Use These APIs?

Anyone who is eligible to participate in QPP, or any entity authorized to report on behalf of someone who is eligible, such as Qualified Registries, Qualified Clinical Data Registries, EHR products, and EHR data submission vendors, can use the APIs. There is no new certification or registration process specific to the use of the APIs.

API calls will be subject to authentication and authorization. Specifications for this functionality will be available soon.

Why Would I Use These APIs?

APIs create new value users and CMS in several ways:

  • APIs offer a more transparent and efficient way to submit performance data than with prior programs
  • APIs will provide real-time scoring and feedback on submitted data
  • Industry partners, like EHRs and registries, can build APIs directly into their products, which enhances their ability to work more effectively with CMS
  • You can use APIs without any CMS-specific certification or registration. However, anyone using the APIs will have to register for an API key. Specifications for retrieving an API key will be available soon.
  • The APIs efficiently handle high submission volume, eliminating the slow performance and downtimes experienced with previous submission methods.

CMS encourages clinicians and third parties to use these APIs in place of prior submission methods (e.g., file upload). However, other submission methods are available and you can view a summary of them below:


Individual Clinician only

QualityImprovement Activities (IA)Advancing Care Information (ACI)CostSubmission Method
Claims
How - 2016

Supply a Quality Data Code (QDC) on a Part B claim.

How – QPP Year 1 (2017)

Supply a Quality Data Code (QDC) on a Part B claim.

How – QPP Year 2 (2018)

Year 2 rules under development, but likely same as Year 1 (2017).


Individual Clinician, or Group Practice of any size

QualityImprovement Activities (IA)Advancing Care Information (ACI)CostSubmission Method
Registry
How - 2016

Registry submits performance data to CMS on behalf of clinician or group by manually uploading Registry XML data file

How – QPP Year 1 (2017)

Registry must make changes to support QPP measures and submission methods.
Preferred method: Registry integrates directly with CMS via an API and passes data in QPP data format.
Alternate method: Registry generates an XML file in QPP data format and submits to CMS via manual file upload on the QPP Website.

How – QPP Year 2 (2018)

Year 2 rules under development, but likely same as Year 1 (2017).


QualityImprovement Activities (IA)Advancing Care Information (ACI)CostSubmission Method
QCDR
How - 2016

Qualified Clinical Data Registry (QCDR) submits performance data to CMS on clinician's or group's behalf by manually uploading QCDR XML data file

How – QPP Year 1 (2017)

QCDR must make changes to support QPP measures and submission methods.
Preferred method: QCDR integrates directly with CMS via an API and passes data in QPP data format.
Alternate method: QCDR generates an XML file in QPP data format and submits to CMS via manual file upload on the QPP Website.

How – QPP Year 2 (2018)

Year 2 rules under development, but likely same as Year 1 (2017).


QualityImprovement Activities (IA)Advancing Care Information (ACI)CostSubmission Method
Attestation
How - 2016

Participants in the Medicare EHR Incentive Program, also known as Meaningful Use, manually attest on the HITECH website.
(Improvement Activities measures did not exist prior to the QPP)

How – QPP Year 1 (2017)

QPP replaces the Medicare EHR Incentive Program, also known as Meaningful Use, with the QPP Advancing Care Information (ACI) measures.
Participants in MIPS may choose to manually attest ACI and the new Improvement Activities (IA) measures using the new QPP Website.

How – QPP Year 2 (2018)

Year 2 rules under development, but likely same as Year 1 (2017).


QualityImprovement Activities (IA)Advancing Care Information (ACI)CostSubmission Method
EHR
How - 2016

Export performance data from an EHR and then manually upload to CMS via the QualityNet or PQRS Portal.

How – QPP Year 1 (2017)

Preferred method: Use an EHR that integrates directly with CMS via an API to submit your data.
Alternate method: Export performance data from an EHR in the new QPP data format or the QRDA-III format then manually upload via the new QPP Website.

How – QPP Year 2 (2018)

Year 2 rules under development, but likely same as Year 1 (2017).


QualityImprovement Activities (IA)Advancing Care Information (ACI)CostSubmission Method
Claims
How - 2016

N/A

How – QPP Year 1 (2017)

CMS will Score performance based on analysis of claims data.

How – QPP Year 2 (2018)

Year 2 rules under development, but likely same as Year 1 (2017).


Group Practice of 25+ Clinicians only

QualityImprovement Activities (IA)Advancing Care Information (ACI)CostSubmission Method
Web Interface
How - 2016

Download Beneficiary Sample data using the CMS Web Interface, add measures data offline and then upload to CMS using the CMS Web Interface.

How – QPP Year 1 (2017)

Quality Reporting
Preferred method: Use an EHR that integrates directly with CMS via an API to download your beneficiary sample, add measures data and return it to CMS.
Alternate method: Use the new CMS Web Interface on the QPP Website to download Beneficiary Sample data, add quality measures data offline and then upload to CMS using the new CMS Web Interface on the QPP Website.

ACI & IA Reporting
Preferred method: Use an EHR that integrates directly with CMS via an API to submit your ACI and IA data.
Alternate method: Export ACI and IA performance data from an EHR in the new QPP data format or the QRDA-III format then manually upload via the new CMS Web Interface on the QPP Website.
Alternate method: Manually attest ACI and IA measures using the new CMS Web Interface on the QPP Website.

How – QPP Year 2 (2018)

Year 2 rules under development, but likely same as Year 1 (2017).


When Can I Use These APIs?

A draft QPP Submissions API specification is available now, which developers can use to learn the API and practice submitting ACI, IA and quality measure data in a sandbox environment. The final Submission API specification will be available on the QPP Website at the beginning of July 2017.

A draft CMS Web Interface API specification for beneficiary sample reporting will be available in Q3 2017.

How Can I Use These APIs?

The APIs are an alternative to less efficient submission methods like file upload and manual attestation. API submissions are subject to the same policy guidelines, data retention, scoring rules and timeframes that apply to all QPP submissions.

Submit Data
When you report data via the APIs, CMS will provide immediate, clear, and actionable feedback. By providing immediate feedback, the APIs enable customers to be confident that they reported their data successfully. If there is a problem with the submission, customers will get the issue specifics right away – and be able to address them immediately. The APIs will also return the preliminary score for your submission. Knowing the score at the time when customers submit the data enables them to know where they stand throughout the process.

Modify, Append and Review Data
You can update or supplement the data you submit via the APIs after the initial submission as long as the submissions window is still open. The system will log changes as you submit them and this log will be accessible via a future API endpoint. You will be able to view the data submitted via the APIs in prior QPP Program Years after the submission window for that Program Year closes.

How Can I Share Feedback?

Please try these APIs and let us know what you think.

Join Our Google Group

Need Help?

CMS provides a number of resources for developers to assist them in using these APIs:

Need Help


The Quality Payment Program Service Center is available to help.

1-866-288-8292

TTY: 1-877-715-6222

Available Monday – Friday, 8:00AM – 8:00PM Eastern Time

Questions


Send us your questions about the Quality Payment Program.

QPP@cms.hhs.gov

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