The Bonus Is Already Allocated. Is Your Documentation Closing the Loop?

A practical guide to Wellpoint’s 2026 Medicare Advantage Pay for Quality (P4Q) program for PCPs and specialists 

By Elizaveta Bannova, Billing Department, WCH; Educational Officer, AAPC 

If you see Medicare Advantage patients through Wellpoint in Arizona, Iowa, New Jersey, South Carolina, Tennessee, Texas, Washington, or West Virginia — there is money sitting on the table right now that most practices are not collecting. 

Wellpoint’s 2026 Pay for Quality (P4Q) program pays providers directly for closing specific care gaps: blood pressure control, diabetes management, cancer screenings, medication adherence, and more. The payments are per patient, per gap closed — and they stack. 

The clinical work is largely things your team is already doing. The question is whether it’s being documented and coded in a way that gets captured. 

This article tells you exactly what the program covers, how the money works, and what to do to start capturing it. 

Key Takeaways