CROSSWALK Appendix K: 2024 Partial QP Election Form (for submission in CY 2025

Partial Qualifying APM Participant (QP) Election Form
CY 2024 Final versus CY 2025 Final
Burden impact: The changes to this form reflect policies in the CY 2025 Physician Fee
Schedule (PFS) Final Rule for the Quality Payment Program. There are no impacts to burden
as a result of these changes.
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Change #1:
Location: Page 1, Line 1
Reason for Change:
Updated performance year.
CY 2024 Final Rule text:
2024
CY 2025 Final Rule text:
2025
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Change #2:
Location: Page 1, Line 2
Reason for Change:
Updated payment adjustment year.
CY 2024 Final Rule text:
2024
CY 2025 Final Rule text:
2025
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Change #3:
Location: Page 1, Line 7
Reason for Change:
Updated calendar year for submission of form.
CY 2024 Final Rule text:
March 31, 2024
CY 2025 Final Rule text:
March 31, 2025
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Change #4:
Location: Page 1, Line 14
Reason for Change:
Updated performance year and payment adjustment year.
CY 2024 Final Rule text:
performance year 2023 (payment adjustment year 2025)
CY 2025 Final Rule text:
performance year 2024 (payment adjustment year 2026)

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Change #5:
Location: Page 1, End of document
Reason for Change:
Updated calendar year for submission of form.
CY 2024 Final Rule text:
Please email the selected and signed form to
QualityPaymentProgramAPMHelpdesk@cms.hhs.gov by March 31, 2024.
CY 2024 Final Rule text:
Please email the selected and signed form to
QualityPaymentProgramAPMHelpdesk@cms.hhs.gov by March 31, 2025.