Medicare Advantage Primary Care Physician Incentive program
The Medicare Advantage Primary Care Physician Incentive (MA-PCPi) program rewards you for helping your patients who are UnitedHealthcare® Medicare Advantage members get the quality care they need to live healthier lives. These patients are also referred to as MA-PCPi Customers.
When you participate in the program, you can earn quarterly and annual bonuses for addressing care opportunities for these patients. The bonus opportunities are established each year. They’re based on our review of feedback from health care professionals like you, and on prioritization of Star Rating measures from the Centers for Medicare & Medicaid Services (CMS).
2024 MA-PCPi information and dates
If there is a conflict between this document and the Terms and Conditions, the MA-PCPi Terms and Conditions control.
2025 incentive opportunities
Eligibility
Each year, we invite eligible primary care physicians to enroll in the program. You'll receive an invitation to participate by mail that details the current year's bonus opportunities and criteria.
Track your progress
You can use Practice Assist to monitor your progress toward these incentive opportunities. It’s available in the UnitedHealthcare Provider Portal in the Clinical & Pharmacy dropdown menu. To access the portal, click Sign In in the upper right corner of this page.
Payout dates
| Quarterly bonus opportunities | |
|---|---|
| Dates of service | Payment date |
| Jan. 1–March 31, 2025 | June 30, 2025 |
| April 1–June 30, 2025 | Sept. 30, 2025 |
| July 1–Sept. 30, 2025 | Dec. 31, 2025 |
| Oct. 1–Dec. 31, 2025 | May 31, 2026 |
| To ensure that the provider is reimbursed as outlined above, we’ll review the provider’s claims and data submissions for the previous quarter(s) and make additional payments, if applicable. | |
| Annual bonus opportunity | |
|---|---|
| Dates of service | Payment date |
| Jan. 1–Dec. 31, 2025 | May 31, 2026 |
- Prioritize which patients should come in for a visit by accessing your Patient Care Opportunity Report (PCOR) or Practice Assist
- PCOR shows which patients are due for preventive care, including screenings, annual care visits or other exams
- Encourage your patients to come in for a visit and schedule their next appointment before they leave
- Ask patients to provide information about their current specialists, prescription medications and exercise level prior to their visit
- Complete a health risk assessment (HRA) during annual wellness visits
- HRAs help identify barriers to health care such as Social Drivers of Health (SDoH) that include housing, transportation, food insecurity, family circumstances and social support
- Document all SDoH ICD-10 Z codes. Access our Social drivers of health Z-code provider guide
Questions?
If you have questions, please contact your UnitedHealthcare representative or practice performance manager. For additional support, visit our Contact us page.