Am I included in MIPS?
To check if you are included or exempt for MIPS, please use this free National Provider Identifier (NPI) search.
Partner with DrChrono to Make MACRA and MIPS Attestation Easy
What is MACRA?
The Medicare Access and CHIP Reauthorization Act (MACRA) was signed on April 16, 2015. It replaced the previous Medicare reimbursement schedule and ended the Sustainable Growth Rate formula with a new pay-for-performance program focusing on quality, value, and accountability instead of the previous fee-for-service model.
Fee-for-Service Pay-for-Performance
MACRA replaced the Physician Quality Reporting System (PQRS), Value-based Payment Modifier (VBM), and the Medicare Electronic Health Record (EHR) incentive program. In doing so, they simplified them into one Quality Payment Program (QPP) with two paths: the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models.
What is MIPS?
The Merit-based Incentive Payment System (MIPS) is a performance-based program where eligible clinicians may earn positive (up to 9%, not including additional positive adjustments for exceptional performance) or negative (up to -9%) payment adjustments for the services they provide to Medicare patients. The 2022 performance year has set the performance threshold to a score of 75 points to earn a neutral payment adjustment for fiscal year 2024 reimbursements.
MIPS 2022 Performance Categories Weights
30%
Each, for Quality and Cost
25%
for Promoting Interoperability
15%
for Improvement Opportunities
What is APM?
The Alternative Payment Model (APM) is a shared risk model that allows practices to earn more by tying more payment to patient outcomes. One immediate benefit from participating in Advanced APMs is a 5% Medicare incentive payment during 2019 through 2024.
Want to Learn More?
Understanding MIPS in 2024
What to Know about the Final Rule, Higher Standards and COVID-19
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