Don’t Forget to Check Your 2019 MIPS Eligibility!

MACRA Minute

Helping you put the pieces together each week!

Access the Quality Payment Program (QPP) Participation Status Tool and enter your 10 digit NPI number to view your MIPS eligibility status for the 2019 MIPS performance year.

Right now, this tool reflects your preliminary 2019 eligibility status based on data from October 1, 2017 to September 30, 2018. Later this year, CMS will review PECOS and Medicare Part B claims data from October 1, 2018 to September 30, 2019, and update the QPP Participation Status Tool to reflect your final 2019 MIPS eligibility status.

Reminder: Clinicians and groups are excluded from MIPS in 2019 if, during either segment of the MIPS determination period, they:

  • Bill $90,000 or less in Medicare Part B allowed charges for covered professional services payable under the Physician Fee Schedule (PFS), OR
  • Furnish covered professional services to 200 or fewer Medicare Part B-enrolled beneficiaries, OR
  • Provide 200 or fewer covered professional services to Medicare Part B-enrolled beneficiaries.

Opt-In Option

Clinicians and groups can elect to “opt-in” to MIPS if they meet or exceed one or two, but not all, of the low-volume threshold criteria. Clinicians and groups who do not exceed any of the low-volume threshold criteria (in one or both segments of the MIPS determination period) may voluntarily report, but are not able to opt-in.

  • Clinicians and groups that opt-in will receive a MIPS payment adjustment in 2021.
  • Clinicians and groups that voluntarily report will receive a MIPS final score, but no payment adjustment will be applied.

For more information: visit the About MIPS Participation page or view the 2019 MIPS Eligibility and Participation Fact Sheet or view the 2019 MIPS Quick Start Guide.

Contact Us to see if we can help you practice succeed with MIPS!