You know that your provider’s conversion factor will be based on their participation in an advanced alternative payment model (APM). Effective Jan. 1, 2026, qualifying participants (QP) will receive a higher conversion factor than non-QPs (
PBN blog, 10/31/25).
But you’re not alone if you don’t know how to confirm a provider's advanced alternative payment model particpation status. That information will tell you the conversion factors for their physician fee schedule and anesthesia services in 2026 and beyond.
During the CPT & RBRVS 2026 Annual Symposium, Emily Yoder, CMS deputy director, explained that a QP is a provider who meets “certain thresholds for participation in an advanced APM.” During a follow-up question-and-answer session, attendees asked how a practice or a vendor such as a billing company can check the provider’s status.
The quickest way is through the CMS
Quality Payment Program participation look up tool, explained Lindsey Baldwin, director with CMS. Anyone who has a provider’s national provider identifier (NPI) can check an individual provider's participation status. You’ll need to log in to the site if you want to check a group’s status.
The screenshot below shows the 2024 participation results for a physician. (Note: we removed their identifying information.)
In 2026, APM-eligible clinicians will receive a conversion factor of $33.5675 compared to a non-APM conversion factor of $33.4009. For anesthesia conversion factors, the APM-eligible rate will be $20.5998 vs. $20.3178 for non-APMs.
