CMS recently released national participation and performance data for the 2022 performance year of the QPP, including data related to MIPS and Alternative Payment Model (APM) participation.

Notable findings include:

  • There were over 386,000 Qualifying APM Participants (QPs) in 2022, up from 333,658 in 2021. QPs are exempt from MIPS and have historically been eligible for a 5% APM incentive payment, which is a lump sum payment based on aggregate paid amounts for Medicare covered professional services furnished by the QP in the previous year. Note that this incentive payment drops to 3.5% in the 2023 performance year and drops further to 1.88% in the 2024 performance year. Starting with the 2025 performance year, QPs will receive a slightly higher annual Medicare Physician Fee Schedule conversion factor update compared to MIPS-eligible clinicians, although there are efforts in Congress to extend the expiring APM incentive payment.
  • Mean and median MIPS performance scores were lower than in previous years.
  • 14% of MIPS eligible clinicians received a penalty in 2024 based on 2022 performance, 37% received a positive adjustment, and 42% received an exceptional performance bonus. Note that 2022 was the last year participants could qualify for the exceptional performance bonus. MIPS payment adjustments are applied on a claim-by-claim basis to Medicare payments for covered professional services furnished by a MIPS eligible clinician.  The maximum penalty for 2024 based on 2022 performance was 9%, while the maximum positive adjustment was 8.26%.
    • Among cardiac electrophysiologists who were eligible to participate in MIPS, only about 10% received a penalty with the remainder receiving either a neutral or positive payment adjustment.

Additional information about 2022 participation/performance data and 2024 payment adjustments is available through the resources below:

Additional resources related to the 2022 PUF, as well as earlier PUFs, can be found on the new Participation and Performance Data page of the QPP website.

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  • Regulatory Updates

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