Quality Payment Program (QPP)
Quality Payment Program
CMS framework that combines MIPS and Advanced APMs to tie physician Medicare payments to quality and value.
1 min read · Last reviewed May 23, 2026
At a glance
- Category
- Compliance Program
- Acronym for
- Quality Payment Program
- Primary sources
- 2
- Workspace handoff
- ask d3 →
Where this comes up
Compliance committees and practice managers operate at this level — written policy, workforce training, sanction policy, monitoring and auditing cadence, response and corrective action. The seven elements of an effective compliance program (OIG) are the scaffolding; this term lives somewhere on that scaffold.
Full definition
What it is in practice
CMS QPP was authorized by MACRA. Most eligible clinicians participate via MIPS; the rest qualify through Advanced APMs.
How it shows up in your practice
Confirm your participation pathway and the categories that apply. MIPS scoring directly affects Medicare payment two years downstream.
Sources
- CMS — Quality Payment Programhttps://qpp.cms.gov/
- CMS — MIPShttps://qpp.cms.gov/mips/overview
Look up QPP details in Ask D3
Open ask d3 →Related terms
- Compliance ProgramMIPSMerit-based Incentive Payment System — the QPP track combining quality, cost, improvement activities, and promoting interoperability into a single composite score that adjusts Medicare payment.
- Compliance ProgramAdvanced APMAn Alternative Payment Model that meets QPP criteria (including downside risk) and qualifies participating clinicians for a 5% lump-sum incentive payment.
- Compliance ProgramValue-Based CareReimbursement models that pay providers based on quality and outcomes rather than fee-for-service volume.
- Compliance ProgramPromoting InteroperabilityThe CMS program (formerly Meaningful Use) that rewards demonstrated use of CEHRT to improve patient care.
D3rx is a healthcare-billing and compliance research aid maintained by D3rx Inc. Articles are drafted by an LLM (Anthropic Claude) against primary HHS, OCR, CMS, eCFR, NIST, and state-regulator publications, and reviewed for restraint and source fidelity by the D3rx team.
Reviewer status: a named credentialed reviewer (CHC, CHPC, or healthcare attorney) is being engaged. Until that engagement is finalized, this page does not claim credentialed review.
Related across the archive
- GlossaryAdvanced APMAn Alternative Payment Model that meets QPP criteria (including downside risk) and qualifies participating clinicians for a 5% lump-sum incentive payment.
- GlossaryMIPSMerit-based Incentive Payment System — the QPP track combining quality, cost, improvement activities, and promoting interoperability into a single composite score that adjusts Medicare payment.
- GlossaryValue-Based CareReimbursement models that pay providers based on quality and outcomes rather than fee-for-service volume.
- GlossaryPromoting InteroperabilityThe CMS program (formerly Meaningful Use) that rewards demonstrated use of CEHRT to improve patient care.
- GlossaryAccountable Care Organization (ACO)A group of providers that takes accountability for the quality, cost, and overall care of a defined patient population.
- SRACMS Promoting Interoperability and the Security Risk Analysis AttestationHow the CMS Promoting Interoperability program (formerly Meaningful Use) requires a HIPAA Security Risk Analysis for each EHR reporting period, what the attestation actually claims, and how CMS audits it after the fact.
- BillingWhat to Do When a Payer Says You're UnderbillingGot a letter saying you're underbilling? Here's what it actually means, whether you should worry, and what action to take.
- ComplianceAmbulatory Surgery Center Compliance: CMS + State + Infection Control42 CFR Part 416 Conditions for Coverage, CMS State Operations Manual Appendix L, the ASC Infection Control Surveyor Worksheet, and where state ASC licensure tightens the standard.
This glossary entry is a research aid for billing and compliance staff. It does not provide legal, medical, or financial advice and does not replace counsel. References cited link to primary sources at HHS, OCR, CMS, eCFR, NIST, and the relevant payer or industry body.