In the fourth year of the Quality Payment Program, CMS is continuing to propose many flexibilities that both make it easy for clinicians to participate and gradually prepare for full implementation of MIPS.
Clinicians or groups with annual Medicare Part B allowed charges over $90,000
AND
See more than 200 Medicare Part B beneficiaries from October 2017 through September 2018.
AND
Provide more than 200 covered professional services to Medicare Part B patients
Clinicians or groups with annual Medicare Part B allowed charges over $90,000
AND
See more than 200 Medicare Part B beneficiaries from September 2016 through August 2017.
Virtual Group reporting available*
*To be eligible to submit as a Virtual Group in the 2019 performance year, all groups need to have received CMS approval prior to December 31, 2018.
Virtual Group reporting available*
*To be eligible to submit as a Virtual Group in the 2018 performance year, all groups need to have received CMS approval prior to December 31, 2017.
If you exceed one or two of the three participation thresholds related to the volume of charges, beneficiaries, and services, you can elect to opt-in to receive a payment adjustment in 2021.
If you do not exceed any of the three participation thresholds, you cannot opt-in, however you can voluntarily report to receive performance feedback without receiving a payment adjustment in 2021
Clinicians who are not eligible to report MIPS have the option to voluntarily report measures and activities to receive performance feedback without receiving a payment adjustment in 2020.
30 points
15 points
+/- 7%
+/- 5%
For any MIPS eligible clinician or group in a small practice (15 or fewer Eligible Clinicians) who submit data on at least 1 Quality measure, 6 bonus points will be added to the Quality category score.
Up to 5 bonus points added to the final MIPS score
1 bonus point earned for each Quality measure submitted without manual intervention
Up to a 10% bonus
Eligible Clinicians must fully participate to qualify for Improvement scoring. Scores are based on the rate of improvement in performance category, not measure specific. Up to 10 points for improvement over prior year.