The MIPS Update from the Centers for Medicare and Medicaid Services

The MIPS 2019 Data Submission Period is Now Open

MIPS Eligible Clinicians Can Start Submitting Data for 2019 through March 31

The Centers for Medicare & Medicaid Services (CMS) has opened the data submission period for Merit-based Incentive Payment System (MIPS) eligible clinicians who participated in the 2019 performance period of the Quality Payment Program. Data can be submitted and updated from 10:00 a.m. EST on January 2, 2020 until 8:00 p.m. EDT on March 31, 2020.

Please note, the data submission period through the CMS Web Interface for ACOs and pre-registered groups and virtual groups also opens on January 2, 2020 and closes on March 31, 2020. Quality measures reported via Medicare Part B claims have been submitted throughout the 2019 performance period. Sign in to qpp.cms.gov for your preliminary feedback on Part B claims measure data processed to date. We’ll update this feedback at the end of the submission period with claims processed by your Medicare Administrative Contractor within the 60 day run out period.  

How to Submit Your 2019 MIPS Data

Clinicians will follow the steps outlined below to submit their data:

1. Go to the Quality Payment Program website
2. Sign in using your QPP access credentials (see below for directions)
3. Submit your MIPS data for the 2019 performance period or review the data reported on your behalf by a third party.

How to Sign In to the Quality Payment Program Data Submission System

To sign in and submit data, clinicians will need to register in the HCQIS Authorization Roles and Profile (HARP) system. For clinicians who need help enrolling with HARP, please refer to the QPP Access User Guide.

Note: Clinicians who are not sure if they are eligible to participate in the Quality Payment Program can check their final eligibility status using the QPP Participation Status Lookup Tool. Clinicians and groups that are opt-in eligible will need to make an election before they can submit data. (No election is required for those who don’t want to participate in MIPS.)

Small, Underserved, and Rural Practice Support

Clinicians in small practices (including those in rural locations), health professional shortage areas, and medically underserved areas may request technical assistance from organizations that can provide no-cost support. To learn more about this support, or to connect with your local technical assistance organization, we encourage you to visit our Small, Underserved, and Rural Practices page on the Quality Payment Program website.

For More Information

• To learn more about how to submit data, please review the resources available in the QPP Resource Library.
• Watch our series of data submission demo videos:
  • Introduction and Overview of 2019 Data Submission
  • File Upload and Quality Scoring
  • Manual Attestation of Improvement Activities
  • Manual Attestation of Promoting Interoperability Measures (coming soon)

Questions?

Please contact the Quality Payment Program at 1-866-288-8292, Monday through Friday, 8:00 AM-8:00 PM ET or by e-mail at: QPP@cms.hhs.gov.

To receive assistance more quickly, consider calling during non-peak hours—before 10 AM and after 2 PM ET. We also encourage you to contact us earlier in the year, as response times often increase with heavier demand as the March 31 data submission deadline approaches.

• Customers who are hearing impaired can dial 711 to be connected to a TRS Communications Assistant.

Check Your Initial 2020 MIPS Eligibility on the QPP Website

You can now use the updated CMS Quality Payment Program Participation Status Lookup Tool to check on your initial 2020 eligibility for the Merit-based Incentive Payment System (MIPS).

Just enter your National Provider Identifier, or NPI, to find out whether you need to participate in MIPS during the 2020 performance period.

Low Volume Threshold Requirements

To be eligible to participate in MIPS in 2020, you must:

• Bill more than $90,000 a year in allowed charges for covered professional services under the Medicare Physician Fee Schedule (PFS), AND
• Furnish covered professional services to more than 200 Medicare Part B beneficiaries, AND
• Provide more than 200 covered professional services under the PFS.

If you do not exceed all three of the above criteria for the 2020 performance period, you are excluded from MIPS. However, you have the opportunity to opt-in to MIPS and receive a payment adjustment if you meet or exceed one or two, but not all, of the low-volume threshold criteria. Alternatively, you may choose to voluntarily report to MIPS and not receive a payment adjustment if you do not meet any of the low-volume threshold criteria or if you meet some, but not all, of the criteria.

Find Out Today

Find out whether you’re eligible for MIPS today. Prepare now to earn a positive payment adjustment in 2022 for your 2020 performance.

Note: The 2020 Eligibility Tool Update for QPs/APMs will be updated at a later time. Additionally, the tool will be updated in late 2020 to indicate final MIPS eligibility.

For More Information

• Visit the How MIPS Eligibility is Determined webpage on the Quality Payment Program website.
• View the 2020 QPP Final Rule Overview Fact Sheet.

Questions?

• Contact the Quality Payment Program at 1-866-288-8292, Monday through Friday, 8:00 AM-8:00 PM ET or by e-mail at: QPP@cms.hhs.gov. To receive assistance more quickly, consider calling during non-peak hours—before 10 AM and after 2 PM ET.
  • Customers who are hearing impaired can dial 711 to be connected to a TRS communications Assistant.