Merit-Based Incentive Payment System (MIPS)

The Merit-Based Incentive Payment System (MIPS) is the program that will determine Medicare payment adjustments. Using a composite performance score, eligible clinicians (ECs) may receive a payment bonus, a payment penalty or no payment adjustment.

Explore the four MIPS performance categories below:

STEP 1: Quality

STEP 2: Improvement Activities

STEP 3: Promoting Interoperability

STEP 4: Cost

2021 MIPS: What You Need to Know to Avoid a Penalty

Wednesday, March 3 at 6 pm (CT)

Register today for AAPM&R's informative webinar on March 3 to review the new 2021 reporting requirements and explain how you can improve your score within each of the four performance categories:

• Quality
• Improvement Activities
• Promoting Interoperability
• Cost

Positive or negative payment adjustments based on a provider’s performance score will be a maximum 9% for the 2021 performance year and 2023 payments.

We’ll go over how to identify appropriate quality measures and improvement activities for your physiatry practice and share strategies to monitor costs and meet promoting interoperability components.

Register today to join us on March 3.

AAPM&R is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. AAPM&R designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

MIPS streamlines three currently independent programs to work as one:

1. Electronic Health Record Incentive Program/Meaningful Use (MU)
2. Physician Quality Reporting System (PQRS)
3. Value-Based Modifier (VBM) 

MIPS also adds a fourth component, Improvement Activities (IA), to promote ongoing improvement and innovation. This new program will ease clinician burden and allow clinicians to choose the activities and measures that are most meaningful to their practice to demonstrate performance.  

Who is eligible for MIPS?

What are exclusions from MIPS?

There are three exclusions of providers from MIPS eligibility:

1. Providers participating in an APM, as defined by MACRA, are not subject to MIPS.
2. Low Volume Threshold: Clinicians who bill less than $90,000 in Medicare beneficiaries in a designated period OR provide care for less than 200 Medicare patients a year are exempt from MIPS. CMS will conduct low-volume status determinations prior to and during the performance period using claims data. 
3. New Medicare-enrolled Eligible Clinicians: Providers who enroll in Medicare for the first time during a performance year are exempt from MIPS until the next subsequent performance year.