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2018 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 2020 payment year.

0-3.75
Downward payment adjustment of -5%
3.76-14.99
Downward payment adjustment of greater than -5% and less than 0%
15
Neutral payment adjustment
15.01-69.99
A final score of 15 or more will avoid the penalty and potentially be eligible for an upward payment adjustment
70+
Earning 70 points or more will earn a 5% upward payment adjustment and possible an exceptional performance bonus

2018 MIPS Reporting Timeline

Performance:

The second performance period opens January 1, 2018 and closes December 31, 2018. During 2018, 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 2018 to the NJII Registry.

Feedback:

CMS will provide feedback reports about performance after data is submitted, and publishing results on Physician Compare in late 2019.

Payment:

Possibly earn a positive MIPS payment adjustment in 2020 if you successfully score above the 15 point threshold as designated by CMs for performance year 2018.

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 seen 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 seen during 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