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.
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
Am I included in MIPS?
To check if you are included or exempt for MIPS, please use this free National Provider Identifier (NPI) search.
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 2021
What to Know about the Final Rule, Higher Standards and COVID-19