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Quality Payment Program (QPP) Support Center

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Use the Updated NPI Look-Up Tool to Check Your 2018 Eligibility Status

6/20/2018

CMS is not sending written letters in the mail to notify clinicians of their 2018 MIPS eligibility status. Therefore, everyone is responsible for checking their 2018 MIPS eligibility status by going to the QPP website
On the home page there is a blue box called "QPP Participation Status is Now Available". Click on the "Check All Years" arrow and then enter an NPI number.  Two tabs appear for PY 2017 and PY 2018. Information displayed includes a reporting requirements overview, practice details for all TINs that the NPI is associated with, if they are an APM participant, and if they need to participate in MIPS as an individual and as a group. Other factors such as special status are also displayed. 
 
Remember that participation requirements changed in 2018, so many providers who were required to participate in 2017 do not need to report this year because they did not bill Medicare Part B $90,000 or more AND see more than 200 Medicare Part B patients during the first look-back period. CMS will review claims and check 2018 eligibility status during a second look-back period and post results later this year.