Merit-based Incentive Payment System

The Merit-based Incentive Payment System (MIPS) is made up of four categories: Quality (replaces PQRS), Improvement Activities, Advancing Care Information (ACI; replaces Meaningful Use), and Cost (Replaces the Value-Based Modifier). 

Your performance in 2018 in these four categories will generate a score that will determine payment adjustments in 2020.

Key Dates

  • December 1, 2017: last day to submit your election to participate in a virtual group. Review requirements in CMS's Virtual Group Toolkit.
  • December 31, 2017: last day of 2017 performance period. Report at last one quality measure on or by this day to avoid a 4-percent negative payment adjustment in 2019.
Are you required to participate?
Who is eligible? Who is excluded?
Eligible clinicians include physicians, NPs, PAs, clinical nurse specialists, and certified registered nurse anesthetists. Clinicians who are qualified participants in Advanced APMs, are new to Medicare Part B, or meet the low-volume threshold are not required to participate. 

Low-Volume Threshold

In 2018, clinicians who see 200 or fewer Medicare Part B patients or have less than $90,000 Medicare Part B charges per year will be exempt from MIPS participation.

This is up from 2017 when the low-volume threshold was set at 100 or fewer Medicare Part B patients or fewer than $30,000 Medicare Part B charges per year. 

This means some clinicians who were required to participate in 2017 will be exempt in 2018.

CMS will inform clincians whether they are excluded from MIPS via letter. Visit to verify your status.