In 2019 CMS required occupational therapy (OT) practitioners to use the Quality Payment Program (QPP) and the Merit-Based Incentive Payment System (MIPS) to relate quality of care to cost-efficient care. OT practitioners must report information on Medicare B beneficiaries using outcome measures to assess functional change and client satisfaction with therapy services. The purpose of this study was to investigate potential correlations between outpatient OT patients’ Focus on Therapeutic Outcomes (FOTO) scores and National Research Corporation Health Real-time (NRCHRT) responses to examine relationships between functional change and client satisfaction. Researchers analyzed retrospective data collected from OT patients with orthopedic upper extremity injuries seen from October 2017 to March 2019 at a large hospital-based outpatient therapy department. Wilcoxon signed-rank test determined a statistically significant median improvement of 20 points in FOTO change scores following therapy for all participants, z= 20.98, p< .001. The participants were grouped into promoters, passives, and detractors based on NRCHRT Net Promoter Score (NPS). A Kruskal-Wallis H test was conducted to determine if there were differences in FOTO change scores between the three groups of participants: promoters (n = 591, Mdn = 21 points), passives (n = 36, Mdn = 19points), and detractors (n = 22, Mdn = 14.50 points). The promoter group had a greater FOTO median change compared to the detractor group. While this was not statistically significant,clinically significant differences were present between groups.