Promoting Interoperability

  • What Is Promoting Interoperability?

    The Promoting Interoperability (PI) category of the Merit-Based Incentive Payment System (MIPS) replaces the meaningful use program that requires physicians to attest annually on meeting certain measures prescribed by the Centers for Medicare and Medicaid Services (CMS).

    In 2019, performance measurement in the MIPS program will be based on four weighted categories.

    • Quality (45 percent),
    • PI (25 percent)
    • Improvement activities (15 percent), and
    • Cost (15 percent).
    Learn How MIPS Works
  • How Do I Meet the Requirements?

    To meet the requirements of the PI category, an EHR is required.

    • If you do not currently use an EHR, you will have to select, purchase, and implement an EHR. Be sure the product you select is certified. TMA has numerous resources to help practices with selection.
    • If you currently use a certified EHR, check with your EHR vendor to ensure the product you use will be upgraded to meet the required metrics. As vendors upgrade, the product must be certified. The next upgrade will be to the 2015 certification criteria, which is required in 2019. View the list of certified products here.


    What should I ask the EHR vendor?

  • 2019 PI Objectives and Measures

    For 2019, eligible clinicians must use technology certified to the 2015 Edition (2015 CEHRT).

    Participants must submit collected data for certain measures from each of the 4 objectives measures (unless an exclusion is claimed) for 90 continuous days or more during 2019.

    In addition to submitting measures, clinicians must:

    • Submit a “yes” to the Prevention of Information Blocking Attestation,
    • Submit a “yes” to the ONC Direct Review Attestation; and
    • Submit a “yes” for the security risk analysis measure

    View Details on 2019 Objectives and Measures

    The above link is to a CMS Zip file, so it may take longer to load than normal files.

  • How Is the PI Category Scored in 2019?

  • How are PI Performance Points Calculated in 2019?

  • PI Scoring Example

  • What Reporting Options Are Available?


    • Be sure to ask your EHR vendor about MIPS reporting options.
    • You don’t have to use the same reporting mechanism for all MIPS categories. For example, you can report PI via attestation, but submit quality measures via a qualified registry. 
    • When using the Group Reporting option, you must use the same identifier for all reporting methods. For example, you cannot individually report PI and then group report quality measures.
  • CMS Data Submission Demos

    See the following demos to find out how to submit your data to CMS.

  • Don't Forget About Audits

    CMS could tap you for a MIPS audit in the future. Here are some things to know to prepare your practice.

    • Document everything (take screen shots)
    • Maintain documentation for 6 years
    • Maintain practice email addresses for notification

    Audit Readiness – What You Need to Know (TMF Quality Innovation Network)

    Learn More About Audit Documentation

  • TMA MACRA-Related Resources 

    TMA reminds you that MIPS will combine parts of the PQRS, VM, and MU programs. If you are new to Medicare’s quality programs or want to know about the latest program requirements, visit TMA’s resource centers to learn more.

    TMA MACRA Resource Center

    TMA EHR Adoption Resources

    TMA Medicaid EHR Incentive Program Resource Center 

  • Articles

    Will You Get a Medicare Bonus or Pay Cut Next Year? Texas Medicine Today, July 11, 2019

    Be On the Lookout for MIPS Audit Request Texas Medicine Today, June 25, 2019

    AMA House Punts on Texas Plan to Fix QPP Texas Medicine Today, June 20, 2019

    TMA to Congress: Undo Payment Freeze, Help Physicians With MACRA Texas Medicine Today, June 11, 2019

    Texans Invite AMA to Join Crusade to Fix QPP Texas Medicine Today, June 4, 2019

    False Impression: Medicine Says Medicare Report Inflates Success of Quality Program Texas Medicine, June 2019

    Making the CEHRT Switch: EHR Upgrade Required for Incentive Payment Programs Texas Medicine, Jan. 2019

    MIPS Audit? Here’s What You Need to Know Texas Medicine Today, Nov. 15, 2018

    75 Ways the Big Medicare Changes Are Very Bad for Physicians and Patients Texas Medicine Today, Sept. 11, 2018


    TMA is helping to strengthen your practice by offering advice and creating a climate of medical success across the state. 

  • What could a TMA membership mean for you, your practice, and your patients?