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Physicians who had temporary Medicare provider access during PHE must complete CMS-855 application

August 22, 2023


The Medicare Access and CHIP Reauthorization Act (MACRA) provides annual incentive payments equal to 5% of qualifying physicians’ Medicare fee-for-service revenues, for physicians who participated in Advanced Alternative Payment Models (APM).

The Centers for Medicare and Medicaid Services (CMS) has begun disbursing these annual incentive payments to qualifying physicians who participated in Advanced APMs during the 2021 performance year, but nearly 6,300 clinicians who qualify have not been paid due to outdated billing or contact information.

Physicians who participated in an Advanced APM in 2021 but have not yet received their incentive payment should review the list of practices that are due money and follow the instructions for providing needed information to CMS to claim these payments before the September 1, 2023 deadline. Even physicians who have left the practice or whose group no longer participates in the APM may be eligible for incentive payments based on their 2021 participation. Physicians who fail to submit bill information before the deadline will forfeit any bonus for the 2021 performance/2023 payment year.

Additional information about what to do if you have not received your incentive payment – including the list of unpaid APM participants and the billing information collection form – is available in the Learning Resources for QP Status and APM Incentive Payment link on the CMS website.  

 

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