Merit-based Incentive Payment System

CMS Releases Updated 2018 MIPS Eligibility Tool

April 11, 2018 01:17 pm News Staff

CMS has finally announced the release of an updated web-based tool to assist physicians in checking their eligibility status for the 2018 Merit-based Incentive Payment System (MIPS).

[physician working on computer keyboard]

This MIPS eligibility tool is easily accessible.(qpp.cms.gov) Physicians simply enter their 10-digit national provider identifier(npiregistry.cms.hhs.gov) in the space provided on the site to see if they should be participating.

Many family physicians around the country have been anxiously awaiting eligibility notification given that the 2018 MIPS performance year began on Jan. 1.

Physicians may remember that in 2017, MIPS-eligible providers were notified by mail in May -- a number of months past the start of that performance year.

So, check that eligibility status right away, and begin working toward a positive Medicare payment adjustment in 2020.

CMS is reminding physicians and other eligible providers that in an effort to reduce the reporting burden on small practices, the agency has changed the eligibility threshold for 2018 to exclude clinicians and groups from MIPS if they

  • bill $90,000 or less in Medicare Part B allowed charges for covered professional services under the physician fee schedule, or
  • furnish services covered under the physician fee schedule to 200 or fewer Medicare Part B patients.

Therefore, physicians checking their eligibility status will find they are identified for participation in the 2018 MIPS performance period if they have billed more than $90,000 in Medicare Part B allowed charges and provided professional services to more than 200 Medicare Part B enrolled beneficiaries.

CMS notes that another tool allowing physicians to look up their participation status for the 2018 alternative payment model will be updated soon.

Physicians who have questions regarding participation in the Quality Payment Program or reporting requirements can get answers via email at qpp@cms.hhs.gov or by calling (866) 288-8292.

Related AAFP News Coverage
AAFP Calls for Further Changes to QPP Interim Final Rule
(12/21/2017)

Quality Payment Program Interim Final Rule
Glean Key Points on 2018 QPP from AAFP Executive Summary

(11/15/2017)

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