CMS Establishes Tool to Check MIPS eligibility

Many practices and providers recently received notices from the Centers for Medicare & Medicaid Services (CMS) informing them of their eligibility for the new Merit-based Incentive Payment System (MIPS). The vast majority of eye care providers are eligible for MIPS and would be expected to participate in 2017 but, in a few select cases, a provider might be excluded (and therefore not have to participate). CMS has noted that providers who are not in an Accountable Care Organization (ACO) who billed Medicare Part B less than $30,000 or see less than 100 Part B enrolled patients in a year don’t participate in MIPS for 2017 (and therefore incur no 2019 MIPS payment adjustment).

Importantly, if you have not received a letter informing you of your MIPS status for 2017 reporting from CMS, there is a new tool on the CMS Quality Payment Program (QPP) website that allows a provider to check by entering their unique NPI number. The site for checking MIPS inclusion can be reached on the QPP site under the “Learn About the Program” page header and then accessing the “Am I included in MIPS” panel. You can also reach it directly by clicking on this link. The NPI is entered directly and the provider clicks “Check Now”.

CMS also notes that those eye care providers who are participating in an Alternative Payment Model should not use the link above. CMS notes they should contact their Center for Medicare & Medicaid Innovation Team.

If you need assistance with the complicated subtleties of MIPS, Corcoran Consulting Group can help.

You can also get and use our new App, Corcoran 24/7 via one of the links below –it’s free. (800) 399-6565

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