The Merit-Based Incentive Payment System or MIPS is designed to provide health care providers who have 100 or more Medicare Part B patients or more than $30,000 in Medicare allowables and are a physician, physician assistant, nurse practitioner, clinical nurse specialist, or certified registered nurse anesthetist with a performance-based payment adjustment to their Medicare payment in 2019.
If you are an eligible health care provider, you can earn a positive payment adjustment by proving that you provided high quality and efficient care that was supported by technology. You can prove this by submitting performance in the following four MIPS categories:
- Quality
- Improvement Activities
- Advancing Care Information
- Cost
Four Options of MIPS Participation
In 2017, you could choose your pace with participation in the MIPS program. The four options of MIPS participation include:- No Participation: If you do not submit any 2017 data, you can expect to receive up to a -4% payment adjustment.
- Minimum Participation: If you send some 2017 data, you can avoid the downward adjustment. Although you likely won’t make any money, you won’t lose any either.
- Partial Participation: If you submit some data for a minimum 90-day period in 2017, you will avoid a negative payment adjustment and may even earn a neutral or small positive payment adjustment.
- Full Participation: If you send data regarding all category requirements, you may earn a moderate positive payment adjustment.
October 2, 2017 Deadline to Fully Participate in MIPS
October 2, 2017 was the last date eligible healthcare providers could fully participate in MIPS and track at least 90 days of performance in each MIPS category. If you have not collected at least 90 days of performance data by October 2, 2017, you will not be eligible to receive a moderate positive payment adjustment in 2019. Instead you can:- Submit the minimum amount of data to avoid a downward payment adjustment.
- Submit no data and receive a downward payment adjustment of up to -4%.