The Merit Based Incentive Payment System (MIPS) was established under Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. MIPS is designed to provide incentives for providers for certain quality measures, improvement activities, and the use of EMRs that meet certain standards. MIPS scoring is based on:
MIPS is one of two tracks in the Quality Payment Program, which was developed to help improve Medicare by helping care givers focus on care quality making patients healthier. It repeals:
Download our MIPS glossary to gain a better understanding of common and not so common MIPS terminology.
CMS wants to increase the focus on quality and value-based care. MIPS is one of the programs designed to help achieve this.
“MIPS” eligible clinicians like physical therapists, occupational therapists and speech-language pathologists who participate in Medicare Part B.
Therapists earn a payment adjustment based on evidence-based and practice-specific quality data. Therapists show they provided high quality, efficient care supported by technology by sending in information in the following categories.
MIPS is comprised of four Performance Categories that make up a composite performance score (CPS) of a possible 100 points. Therapists can submit their individual score or a score for their entire group.
A therapist’s MIPS performance score will factor in performance in 4 weighted performance categories. The scale is based on a 0-100 point scale:
The payment-adjustment year is two years after the data-collection year as will PQRS. That means that when a therapist reports in 2019, the adjustment will be made to payments in 2021.
Under MIPS therapists with composite scores below the performance threshold will be subject to MIPS penalties on a sliding scale, with maximum penalties of up to 7% in 2021, and 9% in 2022 and beyond.