MIPS Overview

How does MIPS work?

Before getting started, check participation status at the following link:

Quality Payment Program (QPP) Participation Status Tool.

You will earn a payment adjustment based on evidence-based and practice-specific quality data.  There are 4 categories for MIPS:

  1. Quality (replaced PQRS)
  2. Improvement Activities (new category)
  3. Advancing Care Information (replaces meaningful use)
  4. Cost (replaces the value based modifier)

For more information on MIPS, visit qpp.cms.gov/mips/overview

2022 Reporting Requirements (Year 6 = 2024 Payment Year)

Final Score:

  • Quality = 30%
  • Promoting Interoperability = 25%
  • Improvement Activities = 15%
  • Cost = 30%

Data Submission:

  • Quality = full year
  • Promoting Interoperability = 90 continuous days of data
  • Improvement Activities = 90 continuous days of data

2021 Requirements (Year 5 = 2023 Payment Year)

Final Score:

  • Quality = 40%
  • Promoting Interoperability = 25%
  • Improvement Activities = 15%
  • Cost = 20%

Data Submission:

  • Quality = full year
  • Promoting Interoperability = 90 continuous days of data
  • Improvement Activities = 90 continuous days of data

2020 Requirements (Year 4 = 2022 Payment Year)

Final Score:

  • Quality = 45%
  • Promoting Interoperability = 25%
  • Improvement Activities = 15%
  • Cost = 15%

Data Submission:

  • Quality = full year
  • Promoting Interoperability = 90 continuous days of data
  • Improvement Activities = 90 continuous days of data

2019 Requirements (Year 3 = 2021 Payment Year)

Final Score:

  • Quality = 45%
  • Promoting Interoperability = 25%
  • Improvement Activities = 15%
  • Cost = 15%

Data Submission:

  • Quality = full year
  • Promoting Interoperability = 90 continuous days of data

Opt-in or voluntarily reporting 

  • Beginning in 2019, there are two ways for clinicians to participate in MIPS if they are not required to participate. Clinicians can either elect to opt-in or voluntarily report.
    • Clinicians who elect to opt-in to MIPS will be subject to a MIPS payment adjustment and will have their data published on Physician Compare
    • Clinicians who choose to voluntarily report to MIPS will not be subject to a MIPS payment adjustment. If you choose to voluntarily report to MIPS your data will be published on the Physician Compare site but you are able to opt out of public reporting during preview period.
  • The decision to elect to opt-in or voluntarily report elected during the submission period before submitting data to CMS is binding and irreversible.

 

2018 Requirements (Year 2 = 2020 Payment Year)

Final Score:

  • Quality= 50%
  • Promoting Interoperability = 25%
  • Improvement Activities = 15%
  • Cost = 10%

 

2017 Requirements (Year 1 =2019 Payment Year)

Final Score:

  • Quality = 60%
  • Promoting Interoperability = 25%
  • Improvement Activities = 15%
  • Cost = 0%