The wait is over! Find out if you need to participate in MIPS

May 1, 2017

Do you have to participate in  the Merit-based Incentive Payment System (MIPS) in 2017? The long awaited answer is scheduled to hit your mailbox later this month from the Medicare Administrative Contractor that processes Medicare Part B claims! The letter will inform each clinician of their participation status based on claims associated with their Tax Identification Number (TIN).

You are required to participate in MIPS if you bill more than $30,000 in Medicare Part B allowed charges AND provide care for more than 100 Part B-enrolled Medicare beneficiaries per year (unless this is your first year participating in Medicare or you are a participant in a qualifying Advanced APM).

MIPS is one part of CMS’ Quality Payment Program which shifts reimbursement from volume of services to quality of services and care for patients. It replaces the outdated Sustainable Growth Rate formula and combines Physician Quality Reporting System, the Value-based Payment Modifier, and the Electronic Health Records Incentive Program.

If you are required to participate, the College has the tools to get you started. Want to simply avoid a MIPS penalty by doing the bare minimum? Follow our step-by-step instructions. Looking to fully report so you can maximize your bonus? Follow our tips to maximize your quality score. Also, our updated MIPS toolkit is coming soon! Stay tuned for updates in Advocacy Insider.