Easy Way to Determine MIPS Participation Status
The Centers for Medicare & Medicaid Services (CMS) has made it easier for clinicians to determine their eligibility in the Merit-based Incentive Payment System (MIPS): A new interactive online tool allows clinicians to determine their status simply by entering their national provider identifier.
Last month, CMS also started sending Medicare-participating clinicians notices in the mail to inform them of their eligibility.
MIPS Eligibility Criteria
To avoid a negative 4 percent payment adjustment to Medicare Part claims in 2019, the following clinicians — who bill Medicare Part B $30,001 or more a year and see 101 or more Medicare patients a year — must submit 2017 performance data:
- Physician assistants
- Nurse practitioners
- Clinical nurse specialists
- Certified nurse practitioners
These clinicians are exempt, however, if they are:
- Newly enrolled in Medicare in 2017;
- See at least 20 percent of their Medicare patients or 25 percent of their Medicare payments through an Advanced Alternate Payment Model; or
- Bill Medicare $30,000 or less in a year or see 100 or fewer Medicare patients in a year.
Clinicians who are exempt from MIPS need not do anything.
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