Check Your Final 2018 MIPS Eligibility Status

You can now check the Quality Payment Program (QPP) Participation Status Tool to view your final 2018 eligibility status for the Merit-based Incentive Payment System (MIPS).

Your initial 2018 MIPS eligibility status was based on CMS review of Medicare Part B claims and PECOS data from September 1, 2016, to August 31, 2017.

Now, we’ve updated your eligibility status based on our second review of Medicare Part B claims and PECOS data, from September 1, 2017, to August 31, 2018.

Checking Your 2018 Eligibility

Your status may have changed, so we encourage you to use the QPP Participation Status Tool to confirm your final 2018 MIPS eligibility.

If, after the first review earlier this year, you were determined to be:

Eligible for MIPS: Your eligibility status might change, and you may no longer be eligible. You should use the tool to make sure you’re still eligible.
Not eligible for MIPS at a particular practice: Your eligibility status, based on your association with that particular practice, will not change.

Please note, if you joined a new practice (meaning you billed under, or assigned your billing rights to, a new or different TIN) between September 1, 2017, and August 31, 2018, we evaluated your MIPS eligibility based on your association with that new practice (identified by TIN) during this second review.

If you joined a new practice after August 31, 2018, you are not eligible for MIPS as an individual based on your association with that new practice (identified by TIN). However, you may be eligible to receive a MIPS payment adjustment based on your group’s participation, if the new practice you joined chooses to participate in MIPS as a group.

Changes to the Low-Volume Threshold in 2018

Remember, we’ve increased the low-volume eligibility thresholds for 2018. Clinicians and groups are now excluded from MIPS if they:

Billed $90,000 or less in Medicare Part B allowed charges for covered professional services during either of the two determination periods (September 1, 2016 – August 31, 2017 or September 1, 2017 – August 31, 2018)

Provided covered professional services to 200 or fewer Part B-enrolled patients during either of the two review periods

In order to be eligible for MIPS, an eligible clinician or group must exceed both criteria listed above.

For More Information

Visit the About MIPS Participation page on the Quality Payment Program website
View the Participating in the Quality Payment Program in 2018 Infographic

Questions?

Contact the Quality Payment Program at QPP@cms.hhs.gov or 1-866-288-8292 (TTY: 1-877-715-6222).

New Quality Payment Program Resources Now Available on the QPP Resource Library

CMS has posted the following new Merit-based Incentive Payment System (MIPS) resources to the QPP Resource Library:

2018 MIPS Cost User Guide: Provides an overview of the MIPS Cost performance category including measures, reporting requirements, and scoring.
2018 MIPS Improvement Activities User Guide: Offers an overview of the MIPS Improvement Activities performance category including participation requirements, reporting methods, and scoring.
2018 MIPS Specialty Measures Guides for Emergency Medicine Clinicians, Ophthalmologists, Optometrists, Orthopedists, Pathologists, Podiatrists, and Primary Care Providers: Offers an overview of MIPS and provides a non-exhaustive list of measures and activities that may apply to these specialty clinicians.
2019 MIPS Quick Start Guide: Provides a high-level overview of who is eligible for MIPS in 2019, and how to participate.
2018 CMS Web Interface Sampling Methodology: Outlines the sampling methodology for the 15 clinical quality measures reported via the CMS Web Interface, and provides background information regarding the number of beneficiaries each organization is expected to report on for purposes of the CMS Web Interface and how those beneficiaries are selected.

We also posted an updated QP Methodology fact sheet, which provides an overview of how CMS determines who is eligible to be a Qualifying Alternative Payment Model Participant (QP) and Partial QP in the Quality Payment Program.

For More Information:

Visit the Quality Payment Program Resource Library for more Quality Payment Program resources.
Go to the Quality Payment Program website to check your participation status, explore measures, and review guidance on MIPS, APMs, what to report, and more.

Questions?

Reach out to your local technical assistance organization.
Contact the Quality Payment Program at QPP@cms.hhs.gov or 1-866-288-8292 (TTY: 1-877-715-6222).

Physician Compare Preview Period is Now Open

The Physician Compare 30-day preview period is officially open as of November 30, 2018 at 10 AM ET (7 AM PT). You can now preview your 2017 Quality Payment Program performance information before it will appear on Physician Compare profile pages and in the Downloadable Database. You can access the secured preview through the Quality Payment Program website.

Check out the resources below on how to preview your data:

For additional assistance with accessing the Quality Payment Program website, or obtaining your EIDM user role, contact the Quality Payment Program service center at QPP@cms.hhs.gov.

To learn more about the 2017 Quality Payment Program performance information and 2016 clinician utilization data that are available for preview, download these documents from the Physician Compare Initiative page:

The 30-day preview period will close on December 31, 2018 at 8 PM ET (5 PM PT).

Please note the 2017 performance information is targeted for public reporting in early 2019 and will be added to Physician Compare and/or the Downloadable Database after all Targeted Reviews are completed. If you have an open Targeted Review request, you will still be able to preview your 2017 Quality Payment Program performance information through the Physician Compare preview period.

If you have any questions about Physician Compare, public reporting, or the 30-day preview period, please contact us at PhysicianCompare@Westat.com.