Your MIPS Action Plan: Step 1 – Am I included in MIPS?
How do I know if I should report?
August 10, 2017
Written by Sharon Phelps
The first step in addressing MIPS is to determine whether or not you need to participate in the program. You don’t want to spend time “stressing and prepping” for a program in which you may not even have to participate.
There are two questions to ask to determine if you must participate:
- Do you have the correct provider type?
For 2017, you are considered a MIPS “Eligible Clinician” if you are registered with PECOS as one of the following provider types:
- Physician Assistant
- Nurse Practitioner
- Clinical Nurse Specialist
- Certified Registered Nurse Anesthetist
Earlier this spring, CMS mailed notification letters to all practices who bill to Medicare Part B. The letter informed you of your participation status for the practice (aka group as defined by those providers billing under a single Tax Identification Number).
If the letter never made it to your inbox, CMS has provided an online tool where you can check your status – it’s right on the main QPP webpage:
If you are not exempt from participation, failing to submit data to the MIPS program will result in a negative 4 percent payment adjustment for all your Medicare Part B Physician Fee Schedule payments in 2019.
For those eligible clinicians who are exempt from participation, you may still want to participate. That is your choice to make. Here are some things to consider:
- If you are exempt as an individual but others in your practice are not exempt, it may be more efficient and financially advantageous for your practice to report as a group.
- Even if you are exempt as an individual, if your practice reports as a group, you will be included!
- If you have been reporting each year to the Meaningful Use program and submitting PQRS measures, you have already done a lot of work to prepare for MIPS! You may wish to continue tracking your performance on quality measures, maintain your momentum with your EHR,and stay familiar with the MIPS program to prepare for reporting in the future.
For more information on the exemptions from MIPS for Eligible Clinicians, look at this blog post:
Have more questions? Need help?
Complete our on-line readiness assessment! It will only take a few minutes to provide us with information to create a customized action plan for you and your practice to be successful in MIPS in 2017 and beyond.
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