10. What happens if I change practices? If you change practices after the completion of a performance year but before the payment adjustment year and begin billing under a new tax identification number (TIN), CMS will carry your performance year score and related payment adjustment forward to your new practice; you would not receive the payment adjustment of your new practice for that payment adjustment year. Thus, CMS will look at your old NPI/TIN performance year data and apply that performance score and adjustment to your new NPI/TIN combination. Your performance with the new practice during the performance year will then be used to assess your payment adjustment for the corresponding payment adjustment year. For example, if you are part of a new practice in 2022, your 2022 payment adjustment will be based on your previous 2020 performance year data and score. Your performance in 2022 with the new practice will then be used to determine your payment adjustment for 2024. What if I am planning to retire in a few years? Should I still participate in MIPS? Participation in MIPS for 2021 will determine payment adjustments beginning January 1, 2023, and this two-year look back for payment adjustments continues for the duration of the program (2022 participation will be used for the 2024 payment adjustment; 2023 performance for the 2025 payment adjustment, etc.). This timeline can be considered as a determining factor for participation. Pages MIPS Participation Eligibility and Exclusions1. How will the low volume exclusion be determined – at the individual or the group level?2. Is the low-volume threshold for allowed charges or Medicare paid amount?3. Are physicians and other eligible clinicians who practice in Federally Qualified Health Centers (FQHCs) and Community Health Centers (CHCs) exempt from MIPS?4. For the purposes of the MIPS exemption, does the low-volume threshold apply to Medicare Advantage patients too?5. Medicare Part B revenue for each physician in my group is less than $90,000 annually, but collectively, the group exceeds this amount. How will CMS determine if my group is exempt from MIPS?6. When will CMS notify individuals who are exempt in 2021?7. Even if I am exempt from MIPS participation, can I still report? If so, am I eligible for / subject to an adjustment? What are the pros and cons of reporting if exempt?8. Is the low-volume threshold based on what was billed / number of patients seen in 2020, or will it be 2021?9. If we are a group of 4 physicians and as a group TIN we do not meet the low volume qualifications, but individually we all qualify as low volume, can we elect to report individually and avoid MIPS?10. What happens if I change practices? Comments are closed.