CMS will reweight MIPS cost category for all clinicians

The Centers for Medicare & Medicaid Services (CMS) will reweight the cost category of the Merit-based Incentive Payment System (MIPS) for all clinicians for the 2021 performance year. CMS said the reweighting is in response to the continuing impact of the COVID-19 public health emergency.

CMS already reweighted the MIPS cost category for most clinicians by automatically applying the Extreme and Uncontrollable Circumstances (EUC) policy. After conducting an analysis, the agency does not believe it can reliably calculate scores for some of the cost measures and adequately capture and reflect the performance of MIPS-eligible clinicians. Therefore, CMS will redistribute the cost category weight (20%) to other categories for all clinicians, including those who reported data as individuals or as part of a group. Physicians do not need to take any action.

The EUC policy assigns eligible clinicians a MIPS final score equal to the threshold, which results in a neutral payment adjustment in the 2023 payment year. CMS did not automatically apply the policy to groups and virtual groups, but allowed them to apply for it. Groups and virtual groups will now have their cost category reweighted too, regardless of whether they applied.

While eligible clinicians will not be scored on the cost category, they will still receive patient-level reports from CMS as part of the final performance feedback scheduled to be released in August.

For additional questions, contact the Quality Payment Program Help Desk (866-288-8292 or qpp@cms.hhs.gov).

— Erin Solis, manager of practice and payment, American Academy of Family Physicians

Posted on April 25, 2022, by Erin Solis