Medicare 2021 APM Incentive Payment Details

2021 APM Incentive Payment Details

The Centers for Medicare & Medicaid Services (CMS) has published 2021 Alternative Payment Model (APM) Incentive Payment details on the Quality Payment Program (QPP) website. To access this information, clinicians and surrogates can now log in to the QPP website using their HARP credentials.

Eligible clinicians who were Qualifying APM Participants (QPs) based on their 2019 performance will begin receiving their 2021 5% APM Incentive Payments this month. CMS has posted the 2021 Learning Resources for QP Status and APM Incentive Payment (ZIP), which includes:

  • 2021 Fact Sheet (PDF): Provides information on APM Incentive Payments based on the 2019 performance year, including who is eligible to receive a payment in 2021 and how payments are determined.
  • 2019 QP Methodology Fact Sheet (PDF): Describes the process and methodology that CMS used to identify who were QPs for the 2019 performance year and who are eligible to receive an APM Incentive Payment in 2021.
  • CPS Codes 2017-2021: Includes the base year codes for calculating 2021 APM Incentive Payments.
  • 2021 Notice & 2021 Billing Information Collection Form (PDF): Informs QPs who are eligible to receive APM Incentive Payments as a result of their 2019 QP status and provides links to several key documents.
  • 2021 Guide (PDF): Explains who is eligible to receive a 2021 APM Incentive Payment based on their QP status in the 2019 performance year, and answers frequently asked questions.
  • 2021 Qualifying Quick Start Guide (PDF): Provides guidance for APM participants who may be QPs in the 2021 performance year.

Payment Details Available on QPP Website

CMS has taken time to ensure correct payments and information are available during the 2021 payment year. CMS’s process includes verifying eligible clinicians’ Advanced APM participation and the calculation of the APM Incentive Payment.

You can now log in to the QPP website to see the amount and the organization paid for both the 10-digit National Provider Identifier (NPI) and the organization.

What Do I Need to Do in Order to Receive the APM Incentive Payment?

You will not need to do anything to receive your payment unless CMS is unable to verify your Medicare billing information. If you do not receive your payment, you should find your name on this public notice, which indicates that you will need to verify your Medicare billing information. If you do not verify your Medicare billing information by November 1, 2021, then CMS will not be able to issue your payment. For instructions on how to verify your Medicare billing information, review the public notice.

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