General Surgery Coding Alert

Reader Question:

Use MIPS Lookup Tool for Your Reporting Requirements

Question: Our practice is transitioning to MIPS, but I’m unclear whether we should send quality data to CMS this year. How can we find out?

Codify Subscriber

Answer: You’re in luck, because CMS now offers a Merit-Based Incentive Payment System (MIPS) Lookup Tool. In 2017, the inaugural year of the Quality Payment Program (QPP), the reporting measure requirements for MIPS eligible clinicians were pretty onerous. Then, eligible clinicians had to bill more than $30,000 in allowable charges under Medicare Part B and provide services to at least 100 Medicare Part B beneficiaries. But for 2018, CMS has changed the requirements: The low-volume threshold changes mean that eligible clinicians must bill over $90,000 or provide services to 200 Medicare Part B beneficiaries in a year.

Luckily, the new MIPS Participation Lookup Tool should illuminate whether you need to submit your quality data for your practice. Check your status here by going to this URL and entering your National Provider Identifier (NPI): https://qpp.cms.gov/participation-lookup/.