CMS Releases 2018 MIPS Eligibility Tool

By David White

The Centers for Medicare and Medicaid Services (CMS) have incorporated a new “MIPS Participation Status” function on the Quality Payment Program (QPP) website.  To find out whether you need to participate in the Merit-based Incentive Payment System (MIPS) during the 2018 performance year, just enter your National Provider Identifier, or NPI.   

To reduce the regulatory burden of MIPS on small practices, CMS has changed the eligibility threshold for 2018. Clinicians and groups are now excluded from MIPS if they:

  • Billed $90,000 or less in Medicare Part B allowed charges for covered professional services under the Physician Fee Schedule (PFS) 

Or

  • Furnished covered professional services under the PFS to 200 or fewer Medicare Part B -enrolled beneficiaries

This means that to be included in MIPS for the 2018 performance period you need to have billed more than $90,000 in Medicare Part B allowed charges for covered professional services under the PFS and furnished covered professional services under the PFS to more than 200 Medicare Part B enrolled beneficiaries.

CMS announced that the 2018 Participation Lookup Tool Update for Alternative Payment Model (APM) participants will be updated at a later time.

Category:
Subcategory:
Author:
David White
Article Image:
Body:

The Centers for Medicare and Medicaid Services (CMS) have incorporated a new “MIPS Participation Status” function on the Quality Payment Program (QPP) website.  To find out whether you need to participate in the Merit-based Incentive Payment System (MIPS) during the 2018 performance year, just enter your National Provider Identifier, or NPI.   

To reduce the regulatory burden of MIPS on small practices, CMS has changed the eligibility threshold for 2018. Clinicians and groups are now excluded from MIPS if they:

  • Billed $90,000 or less in Medicare Part B allowed charges for covered professional services under the Physician Fee Schedule (PFS) 

Or

  • Furnished covered professional services under the PFS to 200 or fewer Medicare Part B -enrolled beneficiaries

This means that to be included in MIPS for the 2018 performance period you need to have billed more than $90,000 in Medicare Part B allowed charges for covered professional services under the PFS and furnished covered professional services under the PFS to more than 200 Medicare Part B enrolled beneficiaries.

CMS announced that the 2018 Participation Lookup Tool Update for Alternative Payment Model (APM) participants will be updated at a later time.

Area(s) of Interest:
Date:
Friday, April 6, 2018