Want to Know If You Need to Participate in MIPS This Year? Here’s How to Find Out

computer7-articleThe 2018 performance year for the Merit-Based Incentive Payment System (MIPS) track of MACRA’s Quality Payment Program (QPP) is now in full swing. If you haven’t begun your 2018 MIPS participation yet, it isn’t too late to start.

You must participate in MIPS if it’s not your first year participating in Medicare Part B and you meet all the following criteria:

  • Are a physician, physician assistant, nurse practitioner, clinical nurse specialist, or certified registered nurse anesthetist.
  • Provide care for more than 200 Medicare patients per year.
  • Bill more than $90,000 in Medicare Part B allowed charge.
  • Not significantly participating in an Advanced Alternative Payment Model (Advanced APM).

You don’t need to report in 2018 if it’s your first year participating in Medicare Part B.

How to Check Your MIPS Participation Status

The Centers for Medicare and Medicaid Services (CMS) will not be sending letters to advise physicians of their MIPS eligibility status this year. The way to check your status is through CMS' MIPS Participation Tool.

CMS has updated its MIPS Participation Tool for the 2018 performance year. You can use the MIPS Participation Tool to find out if you meet the criteria by entering your 10-digit National Provider Identification (NPI) number.

Check MIPS Status 

Note for groups and practices reporting as a group: Physician practices and groups can also use the tool to check their eligibility in 2018. After groups log in to the QPP website, they will be able to click into a details screen to see the eligibility status of every clinician in the group (based on their National Provider Identifier or NPI) to find out whether they need to participate during the 2018 performance year for MIPS. Keep in mind that exempt individual clinicians will still need to report if their group is eligible and chooses to report as a group.

CMS says that it expects to launch a similar tool for participants in the Advanced APMs – the QPP’s other participation track – later during spring 2018.

Additional Resources

Question-Mark-stethescope-articleCMS offers more details on MIPS and Advanced APMS on its Quality Payment Program website at qpp.cms.gov and via its Quality Payment Program resource library here. You can also call the QPP Service Center at 1-866-288-8292 (TTY 1-877-715-6222).

And, for small practices with 15 or fewer clinicians, CMS has also launched an initiative to offer free QPP technical assistance. In Pennsylvania, that initiative is being administered through Quality Insights. Clinicians in small practices can register for QPP support through Quality Insights online here or contact them via email at qpp-surs@qualityinsights.org or phone at 877-497-5065.

The Pennsylvania Medical Society (PAMED) offers a variety of QPP resources including:

PAMED members can also contact our Knowledge Center at 855-PAMED4U (855-726-3348) or KnowledgeCenter@pamedsoc.org.  

 Webinar: 5 Things to Know Now for 2018 MIPS Reporting Success

This webinar on May 30, from 12:15-1 p.m. – hosted by PAMED's Practice Support Team and PAMED's Care Centered Collaborative – offers details on changes to reporting in 2018, how to choose practice measures for your practice, and advice on managing the reporting process.

Register Now

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