CMS Offers Online Tool For Checking MIPS Status

The Centers for Medicare and Medicaid Services (CMS) is offering a new online tool that allows physicians to enter their National Provider Identifier (NPI) to find out their participation status in the Merit-Based Incentive Payment System (MIPS) track of the Quality Payment Program (QPP) this year.

Physicians who bill Medicare Part B more than $30,000 in allowed charges and see more than 100 unique Medicare patients annually may earn bonuses (and avoid penalties) by reporting under MIPS, the new quality improvement program created when the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) eliminated the sustainable growth rate (SGR). MIPS is one of two payment tracks created under MACRA; some physicians will receive incentives for participating in Advanced Alternative Payment Models (AAPMs).

Some physicians are exempt individually from MIPS, but they may be included if their tax identification number (TIN) is reported as a group. The website gives physicians their status for each TIN in which they practice.

Under MIPS, physicians will report measures that are focused on clinical quality and the use of electronic health record (EHR) technology and attest to improvement activities.

• Physicians can pick their pace of participation in MIPS this year.

• To avoid a MIPS pay cut in 2019, physicians must report just one quality measure, one improvement activity, or the base Advancing Care Information measures this year. Physicians who report nothing face a 4 percent pay cut in 2019.

• Physicians who do more than the minimum will have a chance to see an increase in pay in 2019.

• Physicians who are not required to participate in the MIPS program in 2017 can participate voluntarily but will not be subject to MIPS payment adjustments in 2019.

Importantly, with APA’s new patient registry, PsychPRO, reporting quality data is vastly simpler, and members who have not joined PsychPRO are encouraged to do so. CMS has certified PsychPRO as a Qualified Clinical Quality Data Registry for reporting as well as for developing and testing new quality measures. ■