QPP Clinician Participation Letter

By Elizabeth Woodcock, MBA, FACMPE, CPC
May, 2017

The federal government granted an exclusion for many physicians to its Quality Payment Program (QPP), which features the Merit-based Incentive Payment System. Physicians – and other QPP-eligible clinicians - are omitted on the basis of billing less than $30,000 in Medicare Part B allowed charges per year OR providing care for less than 100 Part-B enrolled Medicare patients. According to estimates by the Centers for Medicare and Medicaid Services (CMS), this represents 35% of all eligible clinicians.

Some physicians may see so few Medicare patients, they may know they  don’t have to be concerned with this new program. However, others may wonder whether they meet the exclusion. CMS recently announced that the agency will be mailing letters regarding the exclusion. Due in “late April through May,” the letters will be issued to your practice via your Medicare Administrative Contractor for Part B claims. CMS pledges that these notifications will be “providing the participation status of each MIPS clinician associated with your Taxpayer Identification Number (TIN).”

Elizabeth Woodcock, MBA, FACMPE, CPC

About the Author

Elizabeth Woodcock is the founder and principal of Woodcock & Associates. She has focused on medical group operations and revenue cycle management for more than 20 years and has led educational sessions for the Medical Group Management Association, the American Congress of Obstetricians & Gynecologists, and the American Medical Association. She has authored and co-authored many books. She is frequently published and quoted in national publications including The Wall Street Journal, Family Practice Management, MGMA Connexion, and American Medical News. Elizabeth is a Fellow in the American College of Medical Practice Executives and a Certified Professional Coder. In addition to a Bachelor of Arts from Duke University, she completed a Master of Business Administration in healthcare management from The Wharton School of Business of the University of Pennsylvania.

The contents of The Sentinel are intended for educational/informational purposes only and do not constitute legal advice. Policyholders are urged to consult with their personal attorney for legal advice, as specific legal requirements may vary from state to state and/or change over time.