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On December 1, 2020, the Centers for Medicare and Medicaid Services (CMS) released its 2021 Final Rule for the Quality Payment Program (QPP) that included changes to the merit-based Incentive Payment System (MIPS).

The following changes could affect your practice: 

The minimum threshold was raised by CMS from 45 points to 60 points. This means that you’ll need to attain a minimum of 60 MIPS points to bypass a MIPS penalty. 

The additional performance threshold for exceptional performance will continue to be 85 points. There are no changes to the MIPS payment adjustments, which will stay at +/- 9%. MIPS eligible clinicians who fail to report MIPS in 2021 will receive a -9% MIPS penalty against their 2023 Medicare Part B payments for covered professional services. 

For the quality category, worth up to 40% of your MIPS score, a minimum of 6 measures must be reported on at least 70% of your eligible patients. If you’re reporting on specialty-specific measures, you must report on all measures for each specialty set.

With healthcare evolving each day, changes are expected. If you’re confused or overwhelmed with where to start, don’t worry. At Advantum Health, we can help you navigate the challenges of MIPS/MACRA while you’re busy caring for your patients.