PRACTICING NEUROLOGISTs & ADMINISTRATORs

Merit-based Incentive Payment System

The Merit-based Incentive Payment System (MIPS) is a new approach to paying for Medicare Part B items and services in which clinicians may receive an increase or decrease in their payments based on their performance. 

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.

Check your MIPS participation status online. Just enter your National Provider Identifier (NPI) to determine whether you're required to participate in 2018! Eligibility data is now available at the group and individual level, which will allow you to make strategic participation decisions.

Key Dates

July 1, 2018 
Final 2017 performance year scores and feedback reports available at qpp.cms.gov. Between now and June 30, your preliminary score may change due to special status scoring considerations, shifts in the all-cause readmission quality measure, claims measures to include the 60-day run out period, CAHPS for MIPS survey results, ACI hardship exemptions, improvement study participation, and creation of benchmarks for quality measures without a historical benchmark.

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. 

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.

General MIPS Tools

  • Estimate your MIPS score with the Stratis Health MIPS Estimator tool
    • Note: This is in the process of being updated for 2018

Cost Tools

  • Confused about the new Cost Category? View this 13-minute Cost Quickinar to learn everything you need to succeed in this category in 2018.

Quality Tools

Improvement Activities Tools

 


Promoting Interoperability Tools

  • View this ACI Quickinar to learn all about this MIPS category.
    • Note: CMS recently renamed this category "Promoting Interoperability." This resource is in the process of being updated.
  • Learn the top things to know about Promoting Interoperability (formerly ACI) with the AAN's ACI Top 5
  • See CMS's ACI Fact Sheet

Questions?

Questions about MACRA? Contact us for more information.

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