MIPS Reporting Options
Eligible clinicians and groups will be able to report four categories in the Merit-Based Incentive Payment System (MIPS): Quality, Promoting Interoperability, Improvement Activities, and Cost. Performance scores from the categories are combined into a Final MIPS Score to determine a payment adjustment for the MIPS eligible clinicians or group during the 2023 payment year.
|Final Score 2021||Payment Adjustment in 2023|
|0 - 15||Negative Adjustment of -9%|
|15.01 - 59.99||Negative adjustment between -9% to 0%|
|60||Neutral Payment Adjustment|
|60.01 - 84.99||Positive Adjustment|
|85+||Positive Adjustment + Exceptional Performance Bonus|
MIPS Reporting Timeline
Though you cannot begin submissions until the calendar year ends, your practice should record quality data and how technology is used to support the practice throughout 2021.
To earn a positive MIPS payment adjustment, submit data to the HCIS Qualified MIPS Registry about the care provided and how the practice used technology in 2021.
CMS will provide feedback reports about performance after data is submitted, before the start of payment year.
Practices with sufficient performance in 2021 will receive their positive MIPS payment adjustment in 2023.
Individual vs. Group Reporting
Reporting as an Individual:
- Eligibility is based on >$90,000 in Medicare Part B allowable charges AND >200 Medicare Part B patients AND >200 covered professional services during the designated CMS determination period per NPI/TIN combination.
- An individual is defined as a single clinician, identified by a single National Provider Identifier (NPI) number tied to a single Tax Identification Number (TIN).
- If you report as an individual, your payment adjustment is based upon your MIPS Final Score for the performance year.
Reporting as a Group:
- Eligibility is based on >$90,000 in Medicare Part B allowable charges AND >200 Medicare Part B patients AND >200 covered professional services during the designated CMS determination period by Tax Id Number.
- A group is defined as a single Taxpayer Identification Number (TIN) with 2 or more eligible clinicians (including at least one MIPS eligible clinician), as identified by their National Provider Identifiers (NPI).
- Eligibility is based upon the TIN, each individual clinician included in the TIN regardless of MIPS eligibility will have to report under the group. The TIN will receive a payment adjustment based on the group’s MIPS Final Score for the performance year.
Get In Touch
You can register now to submit through our CMS qualified registry or hire our MIPS advisers to help you through the process. Please use this form if you have additional questions.