It’s Time to File for MIPS

The Merit-based Incentive Payment System, or MIPS, is a quality payment program designed by CMS for eligible clinicians who meet low volume thresholds.  It is used to tie payments to quality and cost-efficient care, drive improvement in care processes and health outcomes, increase the use of healthcare information, and reduce the cost of care.  

MIPS is based on allowed charges for covered professional services under the Medicare Physician Fee Schedule (PFS) and the number of Medicare Part B patients who are provided covered professional services under the Medicare Physician Fee Schedule.  Performance is measured through the data clinicians report in four areas - Quality, Improvement Activities, Promoting Interoperability (formerly Advancing Care Information), and Cost. 

The MIPS Performance Year begins on January 1 and ends on December 31 each year. Program participants must report data collected during one calendar year by March 31 of the following calendar year.  To learn more about the program and to check your participation status, please visit QPP Participation Status.

The following are strategies to help you maximize your potential MAC reimbursement:

  • Establish a Chronic Care Management (CCM) Program - CCM offers a financial incentive for providing a more structured, consistent and proactive approach to patient care between office visits to improve outcomes.
  • Expand Care Coordination - Providers who monitor a patient’s status and coordinate their care as they are referred and/or transition across the continuum of care will be most primed for success.
  • Improve patient engagement - Successful providers will provide real value for their patients by proactively engaging and communicating with them in a relevant, meaningful way at every stage of their healthcare journey.

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