Merit-Based Incentive Payment System and Alternative Payment Model Incentive

  1. Law
  2. CFR 42
  3. Public Health
  4. Centers for Medicare & Medicaid Services, Department of Health and Human Services
  5. Medicare Program
  6. Payment for Part B Medical and Other Health Services
  7. Merit-Based Incentive Payment System and Alternative Payment Model Incentive

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Section
414.1300

Basis and scope.

Section
414.1305

Definitions.

Section
414.1310

Applicability.

Section
414.1315

Virtual groups.

Section
414.1317

APM Entity groups.

Section
414.1318

Subgroups.

Section
414.1320

MIPS performance period.

Section
414.1325

Data submission requirements.

Section
414.1330

Quality performance category.

Section
414.1335

Data submission criteria for the quality performance category.

Section
414.1340

Data completeness criteria for the quality performance category.

Section
414.1350

Cost performance category.

Section
414.1355

Improvement activities performance category.

Section
414.1360

Data submission criteria for the improvement activities performance category.

Section
414.1365

MIPS Value Pathways.

Section
414.1367

APM performance pathway.

Section
414.1370

APM scoring standard under MIPS.

Section
414.1375

Promoting Interoperability (PI) performance category.

Section
414.1380

Scoring.

Section
414.1385

Targeted review and review limitations.

Section
414.1390

Data validation and auditing.

Section
414.1395

Public reporting.

Section
414.1400

Third party intermediaries.

Section
414.1405

Payment.

Section
414.1410

Advanced APM determination.

Section
414.1415

Advanced APM criteria.

Section
414.1420

Other payer advanced APM criteria.

Section
414.1425

Qualifying APM participant determination: In general.

Section
414.1430

Qualifying APM participant determination: QP and partial QP thresholds.

Section
414.1435

Qualifying APM participant determination: Medicare option.

Section
414.1440

Qualifying APM participant determination: All-payer combination option.

Section
414.1445

Determination of other payer advanced APMs.

Section
414.1450

APM incentive payment.

Section
414.1455

Limitation on review.

Section
414.1460

Monitoring and program integrity.

Section
414.1465

Physician-focused payment models.