Last Updated: Jul 11, 2019
Clinicians and practices who participated in the Merit-based Incentive Payment System (MIPS) in 2018 can now view their MIPS performance feedback, including final scores and payment adjustment information.
Your 2018 MIPS performance will affect your Medicare reimbursement in 2020. MIPS eligible clinicians will receive a positive, negative, or neutral payment assessment applied to the Medicare paid amount for covered professional services.
Access MIPS performance and feedback scores by taking these steps:
- Visit the QPP website at qpp.cms.gov/login.
- Login using your HCQIS Access Roles and Profile (HARP) system credentials.
MIPS eligible clinicians who participated in the following MIPS Alternative Payment Models (APMs) can also view performance feedback via the Quality Payment Program (QPP) website: Medicare Shared Savings Program Accountable Care Organization, Next Generation ACO, Comprehensive Primary Care Plus, Oncology Care Model, and Comprehensive ESRD Care.
If you participated in a MIPS APM, the performance feedback will be based on the APM entity score and is applicable to all MIPS eligible clinicians in the entity.
The Centers for Medicare and Medicaid Services (CMS) offers FAQs on 2018 performance feedback here and a detailed 2018 MIPS Scoring Guide here.
How to Request a Targeted Review of Your 2018 MIPS Performance
If you believe that an error has been made in your 2020 MIPS payment adjustment factor calculation, you can request a targeted review. Reasons for requesting a targeted review included (but are not limited to):
- Errors or data quality issues for the measures and activities you submitted
- Eligibility and special status issues (e.g., you fall below the low-volume threshold and should not have received a payment adjustment)
- Being erroneously excluded from the APM participation list and not being scored under the APM scoring standard
- Performance categories were not automatically reweighted even though you qualify for automatic reweighting due to extreme and uncontrollable circumstances
Targeted review applications must be submitted by Sept. 30, 2019. Documentation is required to support your request. If your request is approved, CMS may adjust your final score.
To learn more about the process, check out CMS’ 2018 Targeted Review FAQs and 2018 Targeted Review Fact Sheet.
If you have questions about your performance feedback or MIPS final score, contact the Quality Payment Program by phone at 1-866-288-8292/TTY: 1-877-715-6222 or by email at QPP@cms.hhs.gov.
Pennsylvania Medical Society (PAMED) members with questions can also contact our Knowledge Center at 855-PAMED4U (855-726-3348) or KnowledgeCenter@pamedsoc.org.