Request Help

QPP: Submit a New Help Request

If you would like to submit a question or request support, please complete the form below and click on the "Submit" button at the bottom of the page.

First Name

Last Name

Phone Number

Enter the best email address for us to contact you.
Enter "none" if you do not have an email address.

Confirm Email

Re-enter your email address for confirmation.
Enter "none" if you do not have an email address.

Email Alerts Alert me regarding QPP news and educational events.

Check the box if you would like to receive emails with QPP news and educational events.

Name of Practice or Organization

City

State / Territory

If you are a MIPS-eligible clinician type, you may be eligible to participate in MIPS. Check your eligibility using your NPI at https://qpp.cms.gov/participation-lookup.

Number of
MIPS-eligible clinicians

How many clinicians in your practice may be eligible to participate in MIPS?
If you are not sure about MIPS eligibility, please list the total number of clinicians in your practice.

Describe who you are

Source of Request

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Test ticket Check this if ticket is only to be used for testing or training.

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Question Description

Provide a detailed description of your question.
Please include as many details as possible.

Ticket ID Hash

Your license expired on 2016-07-05 19:54:41Z. Please renew it