MIPS Education MIPS changes in 2021

In this year of the Quality Payment Program, CMS is continuing to propose more flexibility that makes it easy for clinicians to participate and gradually prepare for full implementation of MIPS.

  • 2021

    Clinicians or groups with annual Medicare Part B allowed charges over $90,000

    AND

    See more than 200 Medicare Part B beneficiaries from October 2019 through September 2020. (initial eligibility)
    See more than 200 Medicare Part B beneficiaries from October 2020 through September 2021. (final eligibility)

    AND

    Provide more than 200 covered professional services to Medicare Part B patients

    2020

    Clinicians or groups with annual Medicare Part B allowed charges over $90,000

    AND

    See more than 200 Medicare Part B beneficiaries from October 2018 through September 2019. (initial eligibility)
    See more than 200 Medicare Part B beneficiaries from October 2019 through September 2020. (initial eligibility)

    AND

    Provide more than 200 covered professional services to Medicare Part B patients

  • 2021

    Virtual Group reporting available*

    *To be eligible to submit as a Virtual Group in the 2021 performance year, all groups need to have received CMS approval prior to December 31, 2020.

    2020

    Virtual Group reporting available*

    *To be eligible to submit as a Virtual Group in the 2020 performance year, all groups need to have received CMS approval prior to December 31, 2019.

  • 2021

    If you exceed one or two of the three participation thresholds related to the volume of charges, beneficiaries, and services, you can elect to opt-in to receive a payment adjustment in 2023.

    If you do not exceed any of the three participation thresholds, you cannot opt-in, however you can voluntarily report to receive performance feedback without receiving a payment adjustment in 2023.

    2020

    Clinicians who are not eligible to report MIPS have the option to voluntarily report measures and activities to receive performance feedback without receiving a payment adjustment in 2022.

  • 2021

    60 points

    2020

    45 points

  • 2021

    • Quality 40%
    • Cost 20%
    • Promoting Interoperability 25%
    • Improvement Activities 15%

    2020

    • Quality 45%
    • Cost 15%
    • Promoting Interoperability 25%
    • Improvement Activities 15%

  • 2021

    +/- 9%

    2020

    +/- 9%

  • Small Practice Bonus

    For any MIPS eligible clinician or group in a small practice (15 or fewer Eligible Clinicians) who submit data on at least 1 Quality measure, 6 bonus points will be added to the Quality category score.

    Complex Patient Bonus

    Up to 5 bonus points added to the final MIPS score

    End-to-End electronic reporting

    1 bonus point earned for each Quality measure submitted without manual intervention

    Up to a 10% bonus

    Performance Improvement Bonus for Quality Category

    Eligible Clinicians must fully participate to qualify for Improvement scoring. Scores are based on the rate of improvement in performance category, not measure specific. Up to 10 points for improvement over prior year.

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