Physician Payment and Quality

Medicare makes payments under the physician fee schedule (PFS) for the services of physicians and other health care professionals. Payments are based on the relative resources used to deliver the services. These payment rates are increased or decreased based on physician performance in the Quality Payment Program (QPP).

In addition to fee schedule payments, physicians may participate in alternative payment models under the Medicare program and receive capitated payments, bundled payments, or shared savings. Each year, the Centers for Medicare & Medicaid Services (CMS) issues the PFS/QPP rules that updates payment amounts and sets forth payment policies for physicians and other health care professionals for the calendar year (CY). 
Access resources about the PFS and QPP below.

Medicare PFS and QPP

Video

• CY 2023 PFS Proposed Rule Webinar (2022)  
• CY 2023 QPP and SSP Proposed Rule Webinar (2022)
• CY 2022 PFS Final Rule Webinar (2021)
• CY 2022 QPP Final Rule Webinar (2021)
• CY 2021 PFS Final Rule Webinar (2020)
• CY 2021 QPP Final Rule Webinar (2020)

Comment Letters (PDF)

• AAMC Comment Letter to CMS on CY 2023 PFS/QPP Proposed Rule (2022)
• AAMC Comment Letter to CMS on CY 2022 PFS/QPP Proposed Rule (2021)
• AAMC Comment Letter to CMS on CY 2021 PFS/QPP Proposed Rule (2020)

Regulatory Resources (PDF)

• Medicare Split (Shared) Visits (2022)
• Medicare Critical Care Services (2022)

Clinical Practices Solution Center

The Clinical Practice Solutions Center (CPSC) is a joint product of the AAMC and Vizient that collects billing data from member practice plans to provide benchmarks and help them improve performance.