MIPS Final Rule for 2022

In November 2021, the Centers for Medicare and Medicaid Services (CMS) issued the Final Rule for the 2022 Medicare Physician Fee Schedule, which includes several changes to the Quality Payment Program (QPP) for the upcoming year. But how does this affect the existing MIPS program, and what do you need to know when looking ahead to future clinician reporting?  

About the Merit-Based Incentive Payment System (MIPS) Scoring System 

The Medicare Access and Chip Reauthorization Act of 2015 (MACRA) requires CMS by law to implement and incentive program, referred to as the Quality Payment Program (QPP) that provides 2 tracks: 

  • MIPS – Merit Based Incentive Payment System 
  • APMs – Advanced Alternative Payment Models 

A provider’s MIPS score is calculated based on four performance categories: Quality, Cost, Improvement Activities, and Promoting Interoperability. While these four categories are not changing, the weight of these categories toward a provider’s final MIPS score are changing slightly, thanks to a requirement for Quality and Cost to be weighted equally. 

  • Quality – changing from 40% to 30% 
  • Cost – changing from 20% to 30% 
  • Improvement Activities – stays at 15% 
  • Promoting Interoperability – stays at 15% 

As in years past, points from each performance category are added together to give you a MIPS final score. This score is compared to the MIPS performance threshold to determine if you receive a positive, negative, or neutral payment adjustment. 

Who is eligible for MIPS? 

There are a number of clinician types that are eligible for MIPS. In 2022, there are two new categories that will be eligible: Clinical Social Workers, and Certified Nurse-Midwives. Along with these two new additions, the following clinician types continue to be eligible: Physicians, Osteopathic Practitioners, Chiropractors, Physician Assistants, Nurse Practitioners, Clinical Nurse Specialists, Certified Registered Nurse Anesthetists, Physical Therapists, Clinical Psychologists, Qualified Speech-Language Pathologists, Qualified Audiologists, Registered Dietitians and Nutrition Professionals.  

These clinicians must also meet certain criteria to be eligible, including exceeding all three elements of the low-volume threshold: 

  • Bill more than $90,000 per year in allowed charges or professional services under the Medicare Physician Fee Schedule (PFS), AND 
  • Furnish covered professional services to more than 200 Medicare part B beneficiaries, AND 
  • Provide more than 200 covered professional services under the PFS. 

Learn More about MIPS Final Rule through HCIS 

At HCIS, we specialize in taking 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 take the guesswork out of the changes in 2022 MIPS reporting, as well as give you guidance on successful reporting for the upcoming year. Contact our team to learn more and get started today.