How to Avoid MIPS Penalties

Healthcare clinicians across the country who are eligible for the Merit-Based Incentive Payment System (MIPS) program must report in order to avoid a penalty. In fact, eligible providers can be subjected to a –9% penalty on their 2023 Medicare Part B payments or can earn up to 9% in financial incentives.  

So how do you avoid a –9% penalty? Read on to learn more about the MIPS performance threshold and the parameters your organization must meet in order to avoid a penalty during this year’s MIPS reporting. 

MIPS Performance Categories 

Your MIPS score is calculated based on four different categories: Quality, Cost Improvement Activities, and Promoting Interoperability. Points from each category are totaled to give you a final MIPS score. This score is compared to a performance threshold that yields a positive, negative, or neutral payment adjustment.  

How to Avoid a –9% Penalty 

In order to yield a positive or neutral payment adjustment and avoid the –9% penalty, there are a number of steps your organization must take and attest to in your MIPS reporting, that are based on the size of your practice.  

In order to avoid a penalty your clinician or group will need to earn a minimum of 60 points. Here are the minimum reporting options:  

  • Attest for all required Improvement Activities to achieve 15 points  
  • Small Practices: 1 High-weighted OR 2 Medium-weighted  
  • Large Practices: 2 High-weighted OR 4 Medium-weighted  
  • Maximize score for all Promoting Interoperability measures to earn 25 points 
  • Report on three Quality measures that have a benchmark and meet the data completeness criteria to earn 20 points 

Below is a breakdown of the Final Score vs Payment Adjustment: 

Avoid MIPS Penalties with Healthcare Innovation Solutions 

HCIS helps take the guesswork out of MIPS reporting. Our team has been delivering MIPS registry and consulting services successfully for years and has been qualified by the Centers for Medicare and Medicaid Services (CMS) as a certified registry. We can help you learn about MIPS requirements and performance categories and give you key tips and best practices on how you can report successfully.  

Ready to get started? For help with MIPS reporting or to learn more, contact us today