3. Who am I going to be compared to? Your performance will be compared to CMS’s defined list of “eligible clinicians” who are subject to participation in the MIPS program, regardless of specialty. To be eligible to receive a positive payment adjustment, you must exceed the minimum performance threshold set by CMS for each performance year (for 2023 the performance threshold is 75 points). Once you exceed the performance threshold, the specific percent amount of the payment adjustment that will be applied to your Medicare Part B FFS claims two years later in the payment adjustment year (i.e., 2025 payment adjustment year based on 2023 performance) will depend on how you performed in comparison to your peers. Additionally, there must be budget neutrality, so the total amount of positive payment adjustments must be equal to the total amount of the negative payment adjustments. View PAI’s How QPP Affects Medicare Part B Payment resource for additional details. Pages MIPS Payment Adjustment and Scoring1. Is the MIPS payment penalty applied on a per Medicare Part B claim basis? 2. Is the MIPS positive payment adjustment applied on a per Medicare Part B claim basis or one lump sum bonus payment in 2025?3. Who am I going to be compared to?4. When will I know my Quality Performance status? How often is it measured?5. If more than half of the physicians in a group practice choose not to participate or don’t successfully participate, is everyone in the practice subject to a penalty? Comments are closed.
