Certain Alternative Payment Models (APMs) are considered MIPS APMs and their participants are eligible for certain scoring benefits under MIPS.
MIPS APMs are APMs that meet these criteria:
- APM entities that participate in the APM under an agreement with CMS;
- APM bases payment incentives on performance (either at the APM entity or eligible clinician level), on cost/utilization, and quality measures.
Performance Year
Select your performance year.
2025 MIPS APMs
MIPS APM participants may choose to report MIPS through the APM Performance Pathway (APP).
The APP is an optional MIPS reporting and scoring pathway for
MIPS eligible clinicians
, groups and APM Entities that also participate in MIPS APMs, except for Shared Savings Program ACOs that are required to report through the APP. The APP is designed to reduce reporting burden, create new scoring opportunities for participants in MIPS APMs, and encourage participation in APMs. The APP measures performance across three categories — quality, improvement activities, and Promoting Interoperability.Any APM Entity that participates in a MIPS APM may report via the APP on behalf of their MIPS eligible clinicians. However, the
final score
earned by the APM Entity is applied only to those MIPS eligible clinicians who appear on the APM Entity’s Participation List or Affiliated Practitioner List on one or more snapshot dates. The final score applied to each individual MIPS eligible clinician would be the highest available final score for that clinician (TIN
/NPI
).MIPS reporting and scoring requirements are applicable to all MIPS eligible clinicians, including those reporting the APP.
MIPS APM participation is determined through 4 snapshots between January 1 through December 31.
If you appear on a Participation List or Affiliated Practitioner List on at any snapshot you:
- Will be considered a participant in the MIPS APM, and
- Will be eligible to report the APP
Note: ACOs participating in the Medicare Shared Savings Program are required to report through the APP for purposes of assessing their quality performance for that program. MIPS eligible clinicians participating in Shared Savings Program ACOs have the option to report outside the ACO at the group or individual level for purposes of MIPS scoring.
Extreme and Uncontrollable Circumstances
APM Entities in the following models are eligible to submit an extreme and uncontrollable circumstances exception application for all MIPS performance categories:
- ACO Realizing Equity Access and Community Health (REACH) Model
- Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model
- Enhancing Oncology Model (EOM)
- Guiding an Improved Dementia Experience (GUIDE) Model
- Kidney Care Choices Model (KCC)
- Making Care Primary (MCP)
- Maryland Total Cost of Care Model (MD TCOC)
- Medicare Shared Saving Program
- Primary Care First Model (PCF)
- Vermont All-Payer ACO Model
When you submit an EUC application on behalf of an APM Entity, you are attesting that at least 75 percent of the MIPS eligible clinicians in the APM Entity qualify for reweighting in the Promoting Interoperability performance category.
MIPS APM Participation
You can receive further support through APM Learning Systems.
Join
- Learn about specific MIPS APMs and how to apply.
- Apply to a MIPS APM that fits your practiceand is currently accepting applications.
Current Participants
If you are an eligible clinician currently participating in a MIPS APM (list of APMs linked below), please contact your APM entity for participation specifics.
Download the 2023 and 2024 Comprehensive List of APMs.