Online Publication Date:
15 Jun 2018
Quality Payment Program Look-Up Tool Now Includes 2018 MIPS Eligibility and Predictive Qualifying APM Participant Data

The Centers for Medicare & Medicaid Services (CMS) updated its Quality Payment Program Look-Up Tool , yesterday on June 14th, to allow clinicians to view 2018 Merit-based Incentive Payment System (MIPS) eligibility and Alternative Payment Model (APM) Qualifying APM Participant (QP) data—in one place. Additionally, the look-up tool name was changed from the MIPS Participation Status Tool to the Quality Payment Program Participation Status Tool to reflect the changes CMS made.
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David White
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The Centers for Medicare & Medicaid Services (CMS) updated its Quality Payment Program Look-Up Tool , yesterday on June 14th, to allow clinicians to view 2018 Merit-based Incentive Payment System (MIPS) eligibility and Alternative Payment Model (APM) Qualifying APM Participant (QP) data—in one place. Additionally, the look-up tool name was changed from the MIPS Participation Status Tool to the Quality Payment Program Participation Status Tool to reflect the changes CMS made.

To use the tool, you need to enter your National Provider Identifier (NPI) to find out:

  • Whether you need to participate in MIPS in 2018
  • Your Predictive QP status
     

CMS points out that the Predictive QP status is based on calculations from claims with dates of service between 1/1/17 and 8/31/17. You can learn more about how CMS determines Predictive QP status by accessing the Predictive QP Methodology Fact Sheet .

You can also check the 2018 MIPS clinician eligibility at the group level and APM Predictive QP status at the APM Entity level.

To check your group’s 2018 QPP eligibility:

  • Log into the CMS Quality Payment Program website with your EIDM credentials
  • Browse to the Taxpayer Identification Number affiliated with your group
  • Access the details screen to view the eligibility status of every clinician based on their NPI
     

CMS also announced that you can now download the list of all NPIs associated with your TIN. The downloaded file also includes eligibility information for each NPI. CMS made this enhancement in direct response to stakeholder requests for this function.

For more information, contact the Quality Payment Program Service Center by:

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