Look Out for Your MIPS Participation Status Letter

April 25, 2017

The Centers for Medicare & Medicaid Services (CMS) is reviewing claims and letting practices know which clinicians need to take part in MIPS, the Merit-based Incentive Payment System. MIPS is an important part of the new Quality Payment Program. In late April through May, practices will get a letter from the Medicare Administrative Contractor that processes Medicare Part B claims. This letter will tell the participation status of each MIPS clinician associated with the Taxpayer Identification Number or TIN in a practice.

Clinicians should participate in MIPS for the 2017 transition year if they bill more than $30,000 in Medicare Part B allowed charges a year AND provide care for more than 100 Part B-enrolled Medicare beneficiaries a year.

The Quality Payment Program intends to shift reimbursement from the volume of services provided toward a payment system that rewards clinicians for their overall work in delivering the best care for patients.  It replaces the Sustainable Growth Rate formula and streamlines the “Legacy Programs” Physician Quality Reporting System (PQRS), the Value-based Payment Modifier (VM), and the Medicare Electronic Health Records (EHR) Incentive Program. During this first year of the program CMS is committed to diligently working with you to streamline the process as much as possible.  Our goal is to further reduce burdensome requirements so that you can deliver the best possible care to patients. Learn more about the Quality Payment Program.

View sample letters: 

• MIPS Clinician Participation Letter: http://cmsgov.force.com/newsletter/servlet/servlet.FileDownload?file=015t0000000DEBy
• QPP Letter Individual Clinicians: http://cmsgov.force.com/newsletter/servlet/servlet.FileDownload?file=015t0000000DEC3
• QPP Letter FAQs: http://cmsgov.force.com/newsletter/servlet/servlet.FileDownload?file=015t0000000DEC8