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Centers for Medicare & Medicaid Services Quality Payment Program. Small Practices Newsletter
Quality Payment Program Small Practices Newsletter: November 2024

The Quality Payment Program (QPP) Small Practices Newsletter is a monthly resource that provides small practices (15 or fewer clinicians) with program updates, upcoming QPP milestones, and resources to support their continued participation and success in QPP. We send this newsletter on the second Tuesday of each month.

Please share this newsletter with your fellow clinicians and practice staff and encourage them to sign up [ https://public.govdelivery.com/accounts/USCMS/subscriber/new?topic_id=USCMS_12879%2F&utm_source=newsletter&utm_medium=email&utm_id=newsletter_june2023&utm_content=smallpracsignup ] to receive this monthly resource.

*At-a-Glance: Required and Recommended Activities for Successful Participation in QPP *

Each month, we share required and recommended activities for small practices to support their successful participation in QPP. The activities follow a rolling quarter approach, letting you see activities for the previous month, the current month, and the following month.

QPP-Small-Practices-Timeline-Graphic-Nov-2024-Newsletter

*In This Issue:                                                                                 *


* *Hot Topics: What You Need to Know*
* CY 2025 Medicare Physician Fee Schedule Final Rule and Resources [ #link_1 ]_ _
* MIPS Automatic EUC Policy Applied Following Hurricanes Helene, Francine, and Milton [ #link_2 ]__
* REMINDER: 2025 Virtual Group Election Period Open [ #link_3 ]
* REMINDER: Second Snapshot of 2024 Qualifying APM Participant Status and APM Participation Data Now Available in QPP Participation Status Tool [ #link_4 ] [ #_QP_Determinations_Available ]
* REMINDER: 2024 MVP Registration Open [ #link_5 ]_ _
* Relevant Resources [ #link_6 ]

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CY 2025 Medicare Physician Fee Schedule Final Rule and Resources

The Centers for Medicare & Medicaid Services (CMS) has issued its Calendar Year (CY) 2025 Medicare Physician Fee Schedule (PFS) Final Rule [ https://links-2.govdelivery.com/CL0/https:%2F%2Fwww.federalregister.gov%2Fpublic-inspection%2F2024-25382%2Fmedicare-and-medicaid-programs-calendar-year-2025-payment-policies-under-the-physician-fee-schedule/1/01010192e9bdd634-39d6c3f2-a163-4330-899f-4a0230e0cee4-000000/S-yrQk0MX5HJH3Zegn69o5wHLaumi9uMt5Klqy6uRNc=377 ], which includes policies for the Quality Payment Program (QPP) for the 2025 performance year and beyond. This rule will be published on December 9, 2024, in the Federal Register. 

There are no significant policy changes exclusively for small practices for the 2025 performance year.

Highlights include:


* A performance threshold of 75 points for the 2025 performance year (no change). You’ll avoid a negative payment adjustment in the 2027 payment year if your 2025 final score is 75 points or higher.
* The addition of 7 new *quality measures*, substantive changes to 66 quality measures, and the removal of 10 quality measures.
* The removal of the 7-point cap for scoring certain* topped-out quality measures in specialty sets with limited measures.*
* Changes to our *cost measure scoring methodology.*
* The addition of 6 new *episode-based cost measures* and modifications to 2 existing episode-based cost measures.
* The removal of *improvement activity weighting* and streamlining the reporting requirements for the performance category.

Learn more about the Final Rule and QPP policy changes by reviewing the following resources:


* 2025 QPP Policies Final Rule Fact Sheet (PDF, 2.1MB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3057/2025-QPP-Policies-Final-Rule-Fact-Sheet.pdf ] — Provides an overview of the CY 2025 PFS Final Rule and includes a table that compares current policies to finalized policies and frequently asked questions.
* 2025 Finalized MIPS Value Pathways Guide (PDF, 2.5MB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3058/2025-Finalized-MIPS-Value-Pathways-Guide.pdf ] — Details the newly finalized MIPS Value Pathways (MVPs) and the modifications to previously finalized MVPs for implementation in the 2025 performance year.

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MIPS Automatic EUC Policy Applied Following Hurricanes Helene, Francine, and Milton

In response to Hurricanes Helene, Francine, and Milton, CMS has determined that the Merit-based Incentive Payment System (MIPS) automatic extreme and uncontrollable circumstances (EUC) policy will apply to MIPS eligible clinicians in designated counties in Florida, Georgia, Louisiana, North Carolina, South Carolina, and Tennessee. For a list of counties, please review Appendix B (page 9) in the 2024 MIPS Automatic EUC Policy Fact Sheet (PDF, 762KB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2840/2024-MIPS-Automatic-EUC-Policy.pdf ].


* If you’re located in an identified ZIP code and don’t submit data, you’ll get a neutral payment adjustment for the 2026 MIPS payment year. 
* You can still choose to submit data. If you submit data (as an individual) for 2 or more performance categories, you’ll be scored on those categories and receive a 2026 MIPS payment adjustment based on your 2024 MIPS final score. 

*NOTE:* The MIPS automatic EUC policy doesn’t apply to MIPS eligible clinicians who are participating in MIPS as a group, subgroup, virtual group, or Alternative Payment Model (APM) Entity. However, groups, virtual groups, and APM Entities can request reweighting through the EUC Exception application. Subgroups will inherit any reweighting approved for their affiliated group; they can’t request reweighting independent of their affiliated group’s status. 

For more information, please refer to the 2024 MIPS Automatic EUC Policy Fact Sheet (PDF, 762KB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2840/2024-MIPS-Automatic-EUC-Policy.pdf ].

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REMINDER: 2025 Virtual Group Election Period Open

The 2025 virtual group election period is still open. Solo practitioners and groups with 10 or fewer clinicians interested in this traditional MIPS participation option [ https://qpp.cms.gov/mips/virtual-group-participation ] can submit or modify their election for the 2025 performance period via MIPS_VirtualGroups@cms.hhs.gov.

The following elements must be included in an election: 


* Acknowledgment that a formal written agreement has been established between each Taxpayer Identification Number (TIN) within the virtual group 
* The name and contact information for the official virtual group representative 
* The name and TIN for each practice and all associated National Provider Identifiers (NPIs) under each TIN 

The election period closes on *December 31, 2024, at 11:59 p.m. ET*. 

For more information about virtual group participation and elections, please review the 2025 MIPS Virtual Group Toolkit (ZIP, 2MB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3009/2025-MIPS-Virtual-Group-Toolkit.zip ]. 

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REMINDER: Second Snapshot of 2024 Qualifying APM Participant Status and APM Participation Data Now Available in QPP Participation Status Tool

CMS updated its QPP Participation Status Tool [ https://qpp.cms.gov/participation-lookup ] based on the second snapshot of APM data. The second snapshot includes data from Medicare Part B claims with *dates of service between January 1, 2024, and June 30, 2024*. 

The tool includes 2024 Qualifying APM Participant (QP) status [ https://qpp.cms.gov/apms/advanced-apms ] and MIPS APM participation status. 

To learn more about how CMS determines QP and APM participation status for each snapshot [ https://qpp.cms.gov/apms/apm-determination-periods ], please visit the QPP website [ https://qpp.cms.gov/ ]. 

*What Action Do I Need to Take? *


* Log in to the QPP website and verify your APM Entity information.
* If your information is inaccurate on the QPP website, contact the QPP helpdesk at QPP@cms.hhs.gov.

*How Do I Check My QP or APM Participation Status?* 

To view your QP or APM participation status: 


* Visit the QPP Participation Status Tool [ https://qpp.cms.gov/participation-lookup ]. 
* Enter your 10-digit NPI. 

*What Does QP Status Mean?* 

If you qualify as a QP, this means you’re: 


* Eligible for the 1.88% APM [ https://qpp.cms.gov/apms/overview ] incentive bonus. 
* Eligible for APM-specific rewards. 
* Exempt from participating in MIPS [ https://qpp.cms.gov/mips/how-eligibility-is-determined ]. 

*Learn More* 

For more information on APMs, visit the QPP APM webpage [ https://qpp.cms.gov/apms/overview ]. For a comprehensive list of 2023 and 2024 APMs (PDF, 484KB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2647/2023and2024CompListofAPMs.pdf ] and additional materials, visit the QPP Resource Library [ https://qpp.cms.gov/resources/resource-library ].

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REMINDER: 2024 MVP Registration Open

The MVP registration window is open for the 2024 performance year. Individuals, groups, subgroups, and APM Entities [ https://qpp.cms.gov/apms/mips-apms ] that want to report an MVP can register until *December 2, 2024, at 8 p.m. ET*.

NEW FOR 2024: To register, sign in to the QPP website [ https://qpp.cms.gov/ ] with your Health Care Quality Information Systems (HCQIS) Access and Roles Profile (HARP) account. This is different from the 2023 process of completing an Excel form and emailing the QPP Service Center.

Additional Resources


* 2024 MVPs Implementation Guide (PDF, 1MB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2778/2024-MVPs-Implementation-Guide.pdf ]
* 2024 MVP Registration Guide (PDF, 1MB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2750/2024MVPRegistrationGuide.pdf ]
* 2024 Explore MVPs [ https://qpp.cms.gov/mips/explore-mips-value-pathways?py=2024 ] 

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Relevant Resources

*2024 Small Practice Resources*


* How to Participate as a Group in MIPS (VIDEO) [ https://www.youtube.com/watch?v=dRNd-YMgbHc&list=LL&index=6&t=90s ]
* 2024 Small Practice Action Planning Tool (PDF, 1MB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2954/2024-Small-Practice-Action-Planning-Tool.pdf ]
* Introduction to 2024 Small Practice Action Planning Tool (VIDEO) [ https://youtu.be/4UBAW45RlHk ]
* 2024 MIPS At-A-Glance Reporting Options for Small Practices (PDF, 260KB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2929/2024-MIPS-At-A-Glance-Reporting-Options-for-Small-Practices.pdf ]
* 2024 MIPS Quick Start Guide for Small Practices (PDF, 1MB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2622/2024MIPSGuideforSmallPractices.pdf?utm_source=newsletter&utm_medium=email&utm_campaign=february+2024&utm_id=newsletter_february2024&utm_content=24mipsguidesp ]
* MIPS 2024 Small Practice Eligibility and Participation FAQs (PDF, 461KB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2729/2024-Small-Practice-Eligibility-FAQs.pdf ]
* Do I Need to Participate in MIPS? How to Check Eligibility Status (VIDEO) [ https://www.youtube.com/watch?v=rHoH4hJaetI ]
* Small Practices FAQs [ https://qpp.cms.gov/resources/small-underserved-rural-practices#:~:text=Service%20Center%20Ticket-,FAQs,-Am%20I%20eligible ]
QPP Footer 2023 [ https://qpp.cms.gov/resources/help-and-support ]


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