Medicare Eliminates Cost Category Factor in 2020 MIPS
By Joey Berlin

Medicare is continuing to acknowledge recent extraordinary events in granting physicians relief from its Merit-Based Incentive Payment System (MIPS).

Because of the COVID-19 pandemic, the Centers for Medicare & Medicaid Services (CMS) is throwing out the MIPS Cost category for the 2020 performance year, which will affect physician payments in 2022.

CMS announced that the category, originally weighted at 15% for 2020, will be reweighted to 0%. The 15% weight will be redistributed elsewhere depending on whether physicians are being evaluated for two or three of the remaining categories – Quality, Improvement Activities, and Promoting Interoperability – for 2020.

  • Physicians being evaluated for all three: Quality 55%, Improvement Activities 15%, Promoting Interoperability 30%;
  • Not evaluated on Promoting Interoperability: Quality 85%, Improvement Activities 15%;
  • Not evaluated on Quality: Promoting Interoperability 85%, Improvement Activities 15%; and
  • Not evaluated on Improvement Activities: Quality 70%, Promoting Interoperability 30%.

Because cost data are derived from administrative claims data, participating physicians do not need to take any action as a result of the 2020 Cost reweighting decision.

CMS said it couldn’t reliably calculate scores for the Cost category for several reasons, including concerns about proper risk adjustment to account for COVID-19 care episodes.

The agency also recently announced that as a result of the Texas winter storm in February, many MIPS participants in FEMA-declared disaster areas won’t be required to submit 2021 MIPS data.

For questions about MIPS, you can contact Quality Payment Program staff via email or at (866) 288-8292. You can also contact the TMA Knowledge Center at (800) 880-7955.

Last Updated On

June 01, 2021

Originally Published On

June 01, 2021

Joey Berlin

Associate Editor

(512) 370-1393
JoeyBerlinSQ

Joey Berlin is associate editor of Texas Medicine. His previous work includes stints as a reporter and editor for various newspapers and publishing companies, and he’s covered everything from hard news to sports to workers’ compensation. Joey grew up in the Kansas City area and attended the University of Kansas. He lives in Austin.

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