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2019 MIPS REPORTING OPTIONS

Eligible clinicians and groups will be able to report 4 categories in the Merit-Based Incentive Payment System (MIPS): Quality, Promoting Interoperability, Improvement Activities, and Cost. Performance scores from the categories are combined into a Final MIPS Score to determine a payment adjustment for the MIPS eligible clinicians or group during the 2021 payment year.

0-7.5
Downward payment adjustment of -7%
7.51-29.99
Downward payment adjustment of greater than -7% and less than 0%
30
Neutral payment adjustment
30.01-74.99
A final score of 30 or more will avoid the penalty and potentially be eligible for an upward payment adjustment
75+
Earning 75 points or more will earn a 7% upward payment adjustment and possibly an exceptional performance bonus

2019 MIPS Reporting Timeline

Performance:

The third performance period opens January 1, 2019 and closes December 31, 2019. During 2019, record quality data and how technology is used to support the practice.

Submit Data:

Potentially earn a positive payment adjustment under MIPS by submitting data about the care provided and how the practice used technology in 2019 to the NJII-HCIS Registry.

Feedback:

CMS will provide feedback reports about performance after data is submitted, before the start of payment year.

Payment:

Possibly earn a positive MIPS payment adjustment in 2021 if you successfully score above the 30 point threshold as designated by CMS for performance year 2019.

Individual vs Group Reporting

Report as an individual

Eligibility is based on >$90,000 in Medicare Part B allowable charges AND >200 Medicare Part B patients AND >200 covered professional services during the designated CMS determination period per NPI/TIN combination.

An individual is defined as a single clinician, identified by a single National Provider Identifier (NPI) number tied to a single Tax Identification Number (TIN).
If you report as an individual, your payment adjustment is based upon your MIPS Final Score for the performance year.

Report with a group

Eligibility is based on >$90,000 in Medicare Part B allowable charges AND >200 Medicare Part B patients AND >200 covered professional services the designated CMS determination period by Tax Id Number.

A group is defined as a single Taxpayer Identification Number (TIN) with 2 or more eligible clinicians (including at least one MIPS eligible clinician), as identified by their National Provider Identifiers (NPI).
Eligibility is based upon the TIN, each individual clinician included in the TIN regardless of MIPS eligibility will have to report under the group. The TIN will receive a payment adjustment based on the group’s MIPS Final Score for the performance year.

Determine Your MIPS Eligibility

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Newark, NJ 07102

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qpp@njii.com
973-642-4055