CMS Reporting Requirements for Primary Care

Under CMS's Quality Payment Program (also known as MACRA, the Medicare Access and CHIP Reauthorization Act of 2015), physicians caring for Medicare patients must participate in one of two tracks:

Merit-based Payment System

The Merit-based Payment System (MIPS) – ties Medicare payments to performance against CMS benchmarks for quality, promoting interoperability, improvement activities and cost.

  • MIPS is a complex program with a significant administrative burden
  • Part B payment adjustments can be positive or negative up to 9%, depending on performance


Advanced Alternative Payment Model

An Advanced Alternative Payment Model (Advanced APM) – is a better way to meet requirements without the risk of a penalty, while awarding providers a 3.5% annual increase on their Part B payments for the 2025 payment year.

  • Advanced APM participants are not required to complete MIPS reporting
  • Participants do not risk a negative payment adjustment
  • Participation in the Maryland Primary Care Program confers Advanced AMP status to independent practices that meet the program requirements

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