2023 MIPS payment adjustments take effect

Medicare has begun to apply 2023 payment adjustments for Part B services based on 2021 Merit-based Incentive Payment System (MIPS) scores. Each eligible clinician received a 2021 MIPS final score in August 2022. Those scores, and the associated payment adjustment factors, are available on the Quality Payment Program (QPP) website. The final score associated with each clinician’s Taxpayer Identification Number (TIN)/National Provider Identifier (NPI) determines the payment adjustment applied to their Medicare claims.

MIPS-eligible clinicians will receive a payment adjustment in 2023 if they:

• Were a clinician type included in MIPS,
• Enrolled in Medicare prior to Jan. 1, 2021,
• Were not a Qualifying Alternative Payment Model (APM) Participant (QP),
• Were a Partial Qualifying APM Participant (Partial QP) who elected to participate in MIPS as a MIPS-eligible clinician, and
• Met one of the following criteria:
  • Individually exceeded the low-volume threshold,
  • Were in a practice that exceeded the low-volume threshold at the group level and submitted group or APM Entity data, or
  • Were part of an approved virtual group.

Visit the QPP Resource Library for the 2023 MIPS Payment Adjustment User Guide and more QPP resources.

— Kent Moore, AAFP Senior Strategist for Physician Payment

Posted on Jan. 6, 2023