Resource
Qualifying Payment Amount in Federal IDR
What the QPA is, what payers disclose, and why it is not the only permitted consideration in Federal IDR.
A plan-calculated figure
The QPA is generally tied to the plan's median contracted rate under federal methodology and is used in patient cost sharing and IDR disclosures.
Review the disclosure
Check the QPA, geographic region, service code, modifier treatment, and payer explanation. A certified IDR entity may consider permitted information beyond the QPA, subject to the statute and current rules.