2023 Payment Adjustments for 2021 MIPS Performance Posted

Deadline to Request Targeted Review Is Oct. 21

September 8, 2022, 1:50 p.m. News Staff ― CMS has released 2021 performance feedback for the Quality Payment Program’s Merit-based Incentive Payment System. MIPS-eligible clinicians can now get performance feedback, final score and accompanying MIPS payment adjustment information for 2023 from the QPP website.

To access your information, sign in to your QPP account using your HCQIS Access Roles and Profile system credentials (the same credentials used to submit 2021 MIPS data). After signing in, click “View Feedback” and then select your organization.

MIPS-eligible clinicians and authorized representatives can access

measure-level performance data and scores,
activity-level scores,
patient-level measure reports (if applicable),
performance category-level scores and weights,
final score, and
payment adjustment information.

According to CMS’ 2023 MIPS Payment Year Payment Adjustment User Guide, each physician’s final score determines whether that physician will receive a positive, negative or neutral payment adjustment for covered professional services in the 2023 MIPS payment year.

Story Highlights

The basic performance threshold for the 2023 MIPS payment year is set at 60 points, so if you had a 2021 MIPS final score of 60 points or higher, you will avoid a negative payment adjustment. If you had a final score of 85 points or higher, you’ll receive an additional payment adjustment factor for exceptional performance.

For more information about the performance feedback process, review the following resources:

As in the preceding two MIPS performance years, the 2021 final scores reflect flexibilities adopted in response to the COVID-19 pandemic, including

applying the MIPS automatic extreme and uncontrollable circumstances policy to all individual MIPS-eligible clinicians;
allowing groups, virtual groups and alternative payment model entities to request performance category reweighting through the MIPS EUC exception application; and
reweighting the cost performance category to 0% in traditional MIPS for all MIPS-eligible clinicians, groups and virtual groups.

In addition, in recognition of the unique challenges of managing complex patients during the pandemic, CMS doubled the maximum points available for the complex patient bonus from 5 to 10 points to be added to a physician’s MIPS 2021 final score. Physicians also were able to receive credit for completing the agency’s COVID-19 Clinical Data Reporting With or Without a Clinical Trial improvement activity. Consult the COVID-19 Response fact sheet and COVID-19 Response webpage for more details.

Practice representatives can access both individual and group feedback. Individual physicians and others who represent APM entities may also access their performance feedback from the QPP site using their HARP accounts, although that feedback does not relate to model-specific requirements or assessments outside of the QPP.

Individuals who don’t yet have a HARP account should consult the “Register for a HARP Account” and “Connect to an Organization” documents in the QPP Access User Guide to start the process.

In addition, accountable care organizations participating in the Medicare Shared Savings Program can create and manage a HARP account in the ACO Management System. Physicians can learn how to secure an account through ACO-MS from their ACO. Other questions may be directed to CMS’ ACO Information Center Help Desk at SharedSavingsProgram@cms.hhs.gov or 888-734-6433 (choose option 1).

Finally, if you disagree with your performance feedback and think your MIPS final score should be recalculated, you have until Oct. 21 to request a targeted review. You can do so by signing in with your HARP credentials and clicking “Targeted Review.”

Reasons for requesting such a review could include

data having been submitted under the wrong taxpayer identification number or national provider identifier,
issues related to eligibility and/or special status, or
failure to have performance categories automatically reweighted despite qualifying for reweighting.

For questions regarding whether a particular circumstance merits a targeted review, physicians can contact the QPP Service Desk at QPP@cms.hhs.gov or 866-288-8292.