2017-05-11 12:10:48 UTC

New CMS Tool Helps You Determine MIPS Status

May 11, 2017

Does the Merit-based Incentive Payment System (MIPS) apply to you?

Physicians and other eligible professionals can now use a tool on the CMS Quality Payment Program website to determine their MIPS participation status — “exempt” or “included” — for 2017. To determine your status, you will need your national provider identifier (NPI). 

In 2017, you are included in MIPS if you:

  • Bill Medicare Part B more than $30,000 a year, AND 
  • See more than 100 Medicare patients a year.

You must also be a:

  • Physician.
  • Physician assistant.
  • Nurse practitioner.
  • Clinical nurse specialist.
  • Certified nurse practitioner.

MIPS participation status is based on data in the Medicare Provider Enrollment, Chain, and Ownership System (PECOS) and Medicare claims submitted between Sept. 1, 2015, and Aug. 31, 2016. Errors related to associated tax identification numbers (TINs) and other practice details should be addressed through PECOS. Other errors may be addressed by email to qpp@cms.hhs.gov

CMS recently sent letters in the mail notifying clinicians of their MIPS participation status; review a sample letter. This letter is another source for clinicians to use to determine their status.

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