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Not Sure If You Need to Participate in MIPS? Here’s an Easy Way to Check Online

Physicians and other clinicians now have access to an online tool they can use to see if they need to participate in MACRA's Merit-based Incentive Payment System (MIPS) in 2017. The tool is available through the Centers for Medicare and Medicaid Services (CMS) Quality Payment Program website.

Clinicians can enter their 10-digit National Provider Identifier (NPI) number and click "Check Now" to check their status.


Novitas Solutions has also sent letters to Pennsylvania practices regarding the participation status of each MIPS clinician associated with the Taxpayer Identification Number (TIN) in the practice. Check out the sample letter and appendices to the letter below:

As a reminder, you're eligible to participate in MIPS in 2017 if you bill Medicare Part B more than $30,000 in allowed charges per year, provide care for more than 100 Medicare patients per year, and are one of the following: physician, physician assistant, nurse practitioner, clinical nurse specialist, or certified registered nurse anesthetist. You don't need to report in 2017 if it is your first year participating in Medicare Part B, or if you significantly participate in an Advanced Alternative Payment Model (Advanced APM).

For more details on MIPS, physicians and practices can access these CMS resources:

Small practices with 15 or fewer MIPS eligible clinicians can also check out the Quality Insights QPP Support Center. The QPP Support Center is a CMS-funded initiative which offers MIPS assistance for small practices in Delaware, New Jersey, Pennsylvania, and West Virginia.

PAMED Resources

The Pennsylvania Medical Society (PAMED) has a broad range of resources that can help physicians and practices understand their options and decide how to participate in 2017 in order to avoid a negative adjustment, and potentially earn a bonus, in 2019. Get PAMED's 12-page MACRA guide, a MACRA checklist, and much more online at www.pamedsoc.org/macra.

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

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