If you haven’t already done so, now is the time to check your Merit-Based Incentive Payment System (MIPS) performance feedback, including your 2019 MIPS final score and 2021 payment adjustment, and file a targeted review by Oct. 5, if needed.
This deadline applies to MIPS-eligible clinicians who participated in MIPS directly or as part of a MIPS alternative payment model (APM). It also applies if you qualified for a hardship exception for the 2019 Quality Payment Program (QPP) performance year because of COVID-19 or other reasons under the MIPS Extreme and Uncontrollable Circumstances policy.
Sign in to the QPP portal to check your 2019 MIPS performance feedback (zip file) and 2021 payment adjustment as soon as possible in case the Centers for Medicare & Medicaid Services (CMS) made mistakes. (As a reminder, payment adjustments are assessed two years after the performance year.)
An error would affect the amount of your Medicare bonus or pay cut next year. Or worse, it could result in a pay cut when you should receive an incentive.
If you find errors, request a “targeted review” by 7 pm (CT) today. That means CMS will review your information again and make corrections accordingly. For complete details about this process, refer to the 2019 Targeted Review User Guide.
As a reminder, MIPS final scores cover a 0- to 100-point scale. Your 2019 MIPS final score will determine whether you receive a bonus or pay cut of up to 7%, which will be applied to your Medicare payments for covered professional services furnished under the Medicare physician fee schedule on a per claim basis in 2021.
For the 2019 performance year and 2021 payment year, adjustments will be made based on the following MIPS final scores:
- 0.00-7.50 points = full 7% pay cut;
- 7.51-29.99 points = pay cut up to 7%;
- 30.00 points = no pay cut or bonus;
- 30.01-74.99 = bonus;
- 75.00-100.00 = bonus plus an additional payment for exceptional performance.
For MIPS questions, contact the QPP Service Center at (866) 288-8292 or via email at QPP@cms.hhs.gov. If you need help from MIPS experts, contact the TMF Health Quality Institute for no-cost assistance on how to interpret your performance feedback, final score, and payment adjustment, or how to request a targeted review.
As always, visit the Texas Medical Association MACRA Resource Center for more information.
Last Updated On
October 05, 2020
Originally Published On
September 21, 2020