The QPP MIPS participation starts from knowing the eligibility status. For MIPS 2020, clinicians can check eligibility via QPP Lookup Tool. Later on, CMS updates if physicians are eligible for MIPS data submission or not.
However, the reporting requirements change each year due to changed policies. So, if we want to succeed in this program, we have to comply with the changes.
We have almost 2 months to submit data to CMS. Most of you must have checked their MIPS eligibility status up until now. However, to ensure quality, go through this article to review the complete process.
Also, remember that MIPS participation is not easy, and the eligibility check is just the start. A MIPS Qualified Registry can take care of the administrative load without you being bothered. So, consult them for a seamless process.
According to the official website, interested clinicians must have:
A TIN is required when you own a practice; belong to a hospital as a medical facility or a medical practice.
In the case of physicians’ reassignment of Medicare Billing Rights to TIN, their NPI gets associated with that TIN, referred to as TIN/NPI combination.
For Instance, if any physician has assigned billing rights to multiple TINs, he/she will have multiple TIN/NPI combinations.
CMS assesses TIN/NPI combination for MIPS eligibility and uses TINs for practices’ eligibility.
CMS looks into past and current Medicare Part B Claims and Provider Enrollment, Chain, and Ownership System (PECOS) data for clinicians and practices, each year twice.
Data analysis from the first segment is referred to as preliminary eligibility. Data from the second review are then attached to the first segment of data and presented for final eligibility determination. The requirement is to pass the Low-Volume Threshold (LVT) during both reviews.
LVT includes three aspects of professional healthcare services as follows.
Other than exempt cases, physicians are required to participate in QPP MIPS 2020, if they:
It is to consider if physicians report Medicare Part B claims in the second review with a medical practice’s TIN, the eligibility status at that practice will only reflect data from 2nd review.
CMS has an eligible clinician type. Clinicians falling into the list and satisfying all the requirements can participate in MIPS.
Eligible physicians can report data to CMS as individuals, a group, or a virtual group.
For MIPS participation as individuals, physicians must:
For MIPS participation as a group, physicians must:
The MIPS score and payment adjustment will be awarded as a group in this case.
For MIPS participation as a virtual group, physicians must:
The above-mentioned are all the requirements that a MIPS participant should know beforehand of the MIPS data submission. We are halfway through QPP MIPS 2020, and many professionals already had planned and implemented a strategy for optimized performance in the end.
Physicians have a lot on their plate already, and the pandemic has increased their burden. In such a situation, MIPS quality reporting seems like a challenging task.
If you’re an eligible MIPS clinician, the best advice to you is to concentrate on quality care outcomes. A professional MIPS Qualified Registry will take your efforts into account, and you can target more measures if you have a proper plan of action on board.
Best of luck.
