• The Centers for Medicare and Medicaid Services (CMS) has added physical therapists (PTs) to the list of providers in the CMS Quality Payment Program (QPP). As of January 2019, PTs providing services under Medicare Part B who meet qualifying criteria must participate in either the Merit-based Incentive Payment Program (MIPS) or an Advanced Alternative Payment Model (Advanced APM).

    Others who are not required to participate still may be eligible.

    Reduce Your Administrative Burden

    MIPS requires several data points to be reported electronically through CMS-certified registries. APTA's Physical Therapy Outcomes Registry is a Qualified Clinical Data Registry (QCDR) and approved by CMS to report MIPS data on your behalf.

    The Registry integrates seamlessly with your EHR.

    You benefit from:

    • More ways to earn MIPS points to reach your 7% incentive payment
    • More measures than any other physical therapy registry on the market
    • Real-time feedback, so you can track your MIPS score throughout the year
    • Outcomes analytics to promote your practice
    • No additional data entry, saving your practice time and money

    Criteria for Mandatory MIPS Participation

    You must participate in MIPS and are subject to the payment adjustment of +/-7% if you are a PT in a private practice and meet all 3 of the following low-threshold criteria:

    • Annually receive more than $90,000 in Medicare part B payments
    • Provide care for more than 200 Part B-enrolled Medicare beneficiaries
    • Bill more than 200 professional services

    Nonparticipation will result in the full 7% penalty. Visit the CMS website to determine your eligibility.

    Boost Your Bottom Line With Opt-In Participation

    With no scheduled Medicare payment updates until 2025, choosing to participate in MIPS gives you the opportunity to earn up to an additional 7% annually. Here's how it works:

    • If you are in a private practice and exceed 1 or 2 of the low-volume threshold criteria as an individual PT, you are eligible to opt in to MIPS and are subject to the payment adjustment of +/-7%.
    • If your practice collectively exceeds 1, 2, or all 3 of the low-volume threshold criteria it can opt in to MIPS as a group and is subject to the payment adjustment of +/-7%.

    Please note, if you or your group does not meet at least 1 of the eligibility requirements, you are not eligible for MIPS participation and you cannot earn an incentive payment.

    Learn more about participating in MIPS.

    Measures in the Registry

    The Registry supports 15 Quality Payment Program (QPP) measures and 12 QCDR measures for PTs within the MIPS reporting program. Please click on the individual measures to learn more:

    2019 Qualified Clinical Data Registry (QCDR) Measures

    • IROMS11: Failure to Progress (FTP): Proportion of patients failing to achieve a Minimal Clinically Important Difference (MCID) to indicate functional improvement in knee rehabilitation of patients with knee injury measured via their validated Knee Outcome Survey (KOS) score, or equivalent instrument which has undergone peer reviewed published validation and demonstrates a peer reviewed published MCID. Download in Adobe PDF.
    • IROMS12: Failure to Progress (FTP): Proportion of patients failing to achieve a Minimal Clinically Important Difference (MCID) in improvement in pain score, measured via the Numeric Pain Rating Scale (NPRS), in revalidation patients with knee injury pain. Download in Adobe PDF.
    • IROMS13: Failure to Progress (FTP): Proportion of patients not achieving a Minimal Clinically Important Difference (MCID) to indicate functional improvement in rehabilitation of patients with hip, leg or ankle injuries using the validated Lower Extremity Function Scale (LEFS) score, or equivalent instrument which has undergone peer reviewed published validation and demonstrates a peer reviewed published MCID. Download in Adobe PDF.
    • IROMS14: Failure to Progress (FTP): Proportion of patients failing to achieve a Minimal Clinically Important Difference (MCID) in improvement in pain score, measured via the Numeric Pain Rating Scale (NPRS), in rehabilitation patients with hip, leg or ankle (lower extremity except knee) injury. Download in Adobe PDF.
    • IROMS15: Failure to Progress (FTP): Proportion of patients failing to achieve a Minimal Clinically Important Difference (MCID) to indicate functional improvement in rehabilitation of patients with neck pain/injury measured via the validated Neck Disability Index (NDI). Download in Adobe PDF.
    • IROMS16: Failure to Progress (FTP): Proportion of patients failing to achieve a Minimal Clinically Important Difference (MCID) in in improvement in pain score, measured via the Numeric Pain Rating Scale (NPRS), in rehabilitation patients with neck pain/injury. Download in Adobe PDF.
    • IROMS17: Failure to Progress (FTP): Proportion of patients failing to achieve a Minimal Clinically Important Difference (MCID) to indicate functional improvement in rehabilitation patients with low back pain measured via the validated Modified Low Back Pain Disability Questionnaire (MDQ) score. Download in Adobe PDF.
    • IROMS18: Failure to Progress (FTP): Proportion of patients failing to achieve a Minimal Clinically Important Difference (MCID) in improvement in pain score, measured via the Numeric Pain Rating Scale (NPRS), in revalidation patients with low back pain. Download in Adobe PDF.
    • IROMS19: Failure to Progress (FTP): Proportion of patients failing to achieve a Minimal Clinically Important Difference (MCID) to indicate functional improvement in rehabilitation of patients with arm, shoulder, and hand injury measured via the validated Disability of Arm Shoulder and Hand (DASH) score, Quick Disability of Arm Shoulder and Hand (QDASH) score, or equivalent instrument which has undergone peer reviewed published validation and demonstrates a peer reviewed published MCID. Download in Adobe PDF.
    • IROMS20: Failure to Progress (FTP): Proportion of patients failing to achieve a Minimal Clinically Important Difference (MCID) in in improvement in pain score, measured via the Numeric Pain Rating Scale (NPRS), in rehabilitation patients with arm, shoulder, or hand injury. Download in Adobe PDF.
    • FORCE20: Review of Functional Status Assessment for Patients with Osteoarthritis. Download in Adobe PDF.
    • FORCE21: Review of Pain Status Assessment for Patients with Osteoarthritis. Download in Adobe PDF.

    2019 QPP Measures

  • Last Updated: 1/28/2019
    Contact: registry@apta.org