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QPP Eligibility Criteria

QPP-eligible clinicians must:

  • Bill more than $90,000 for Medicare Part B covered professional services, and
  • See more than 200 Medicare Part B patients, and
  • Provide more than 200 covered professional services to Medicare Part B patients.

To determine if you are an eligible clinician, see: QPP Participation Status Tool.

Note: If you do not meet the criteria above, you may choose to opt-in to the program (and will receive a payment adjustment). Alternatively, you may voluntarily report and track your quality scores.

The maximum payment adjustment remains at +or – 9 percent.

  • The performance threshold remains at 75 points for the Calendar Year (CY) 2025 performance period/2027 MIPS payment year.  The performance threshold is the number against which your final score is compared to determine your payment adjustment.
  • CMS maintains the 75 percent data completeness criteria threshold through the 2028 performance period/2030 MIPS payment year. This means you must report on 75 percent of all eligible cases for each measure you choose to report.
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Designated Audiology Quality Measures Set

Current audiology measures are:

MIPS - eligible clinicians may choose any 6 measures to report. Audiologists are not required to report on all measures in the audiology measures set.

Resources

Measure specifications and supporting documentation (such as single source documentation that lets you search for codes that qualify for a given measure) are posted on the CMS QPP Resource Library QPP Resource Library.

The Audiology Quality Consortium hosted two webinars on participation in the Qualty Payment Program.

Click the following links to access the webinars:

References