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A Guide to QPP 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:

Submission Methods

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 Electronic Health Record (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).

Need Help?

There is a Google Group where developers can interact with one another to ask questions, find answers, leave feedback and share experiences using these APIs. Developers who are unable to find answers using the Google Group, or who have questions related to policy, should contact the QPP Service Center.

Join the Google Group

Get Help From CMS

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