Submit 2020 Data Now to Avoid Medicare Pay Cut
By David Doolittle

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If you participated in Medicare’s Quality Payment Program (QPP) under the Merit-Based Incentive Payment System (MIPS), the window to submit data to the Centers for Medicare & Medicaid Services (CMS) opened Jan. 4 and closes March 31. The deadline to submit all claims under the Quality performance category is March 1.  

At stake for the 2020 QPP performance year is a 9% cut to your Medicare payments in 2022. 

Among notable elements of MIPS for 2020:

  • The scoring threshold to earn a bonus payment will be 45 points. A score of less than 45 points leaves a physician subject to a payment cut of up to 9%. 
  • The threshold to earn an additional bonus for exceptional performance is 85 points in 2020, up from 75 in 2019.  

However, you could be eligible for an exception to meeting MIPS program requirements if you have issues with interoperability or experience an “extreme and uncontrollable circumstance” that impacts practice operations or your ability to collect or submit MIPS data. For performance year 2020, CMS has categorized the effects of COVID-19 on practices as an extreme and uncontrollable circumstance. The agency also has extended the deadline to apply for a COVID-19 related exception to Monday, Feb. 1.

Beginning this year, you must have a HCQIS Access Roles and Profile (HARP) account to submit an exception application.  Sign in to qpp.cms.gov with your HARP account to complete the online application.

Physicians can submit data by qualified registry, qualified clinical data registry, electronic health record, web interface, survey vendor, and/or self-attestation

If you participated in an Alternative Payment Model (APM) such as the Medicare Shared Savings Program or one of the CMS bundled payment programs in 2020, you most likely will be scored under the APM standard within MIPS. Contact your APM administrator for details and ask if you need to submit any MIPS data. 

For answers to your MIPS and APM questions, contact the QPP Service Center at (866) 288-8292 or by email at QPP@cms.hhs.gov. To avoid long wait times, call during non-peak hours, which are before 9 am and after 1 pm CT. 

Last Updated On

January 08, 2021

Originally Published On

December 02, 2020

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David Doolittle

Editor

(512) 370-1385

Dave Doolittle is editor of Texas Medicine and Texas Medicine Today. Dave grew up in Austin, where he attended culinary school as well as the University of Texas. He spent years covering Central Texas for the Austin American-Statesman newspaper. He is the father of two girls, a proud Longhorn, and an avid motorsports fan.

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