Posted on June 27, 2019
The 2019 MIPS performance period is in full swing. MIPS eligible clinicians and groups must achieve at least 30 MIPS points in 2019 to avoid any penalty. If they choose not to report, it’s an automatic 7% penalty against their 2021 Medicare Part B payments. We have developed this MIPS Reporting Checklist to explain your reporting options and help you plan your strategy for participating in MIPS this year.
STEP 1: Choose to report as an individual or a group.
Providers can choose to report as an individual or as a group if they have 2 or more clinicians who bill with the same Tax Identification Number (TIN). There are several advantages to group reporting:
When reporting as a group, performance data is aggregated across the TIN for all clinicians, so you will receive the collective score of the group for all 4 MIPS categories and the same payment adjustment as everyone else in the group. There will be one MIPS submission under your TIN, rather than a separate submission for each clinician.
More information about the benefits of group reporting can be found here.
STEP 2: Decide your reporting goals.
Are you looking to simply avoid the automatic 7% penalty (neutral payment adjustment), or do you want to try to maximize your Medicare reimbursement? Whatever your reporting goals, you have several reporting options to choose from.
- Avoid the Penalty - Learn how to report a minimal amount of data to achieve 30 MIPS points and avoid the penalty by clicking here.
- Earn a Positive Payment Adjustment - Learn how to increase your MIPS scores and maximize your Medicare reimbursement by clicking here.
STEP 3: Determine which MIPS performance categories you will report.
Your 2019 MIPS score will be based on performance in 4 categories:
Quality - This category is worth a maximum of 45 points. Eligible MIPS clinicians and groups must report 6 Quality measures, with at least 1 measure being an Outcome measure (or a High Priority measure if an Outcome measure is not available).
You can review all of the available 2019 Quality measures here or review suggestions for your specialty here.
Promoting Interoperability - This category is worth a maximum of 25 points. A 2015 edition certified Electronic Health Record (EHR) is required for this category and measures must be reported for a minimum of 90 consecutive days in 2019. CMS will reweight this category to 0 and reallocate the performance category weight of 25% to the Quality performance category for certain providers who qualify for automatic reweighting or who receive approval of a hardship exception application.
More information on Promoting Interoperability, and how to attest to this category in your MDinteractive account, can be found here.
Improvement Activities - This category is worth a maximum of 15 points. It remains a simple attestation process for activities performed for a minimum of 90 consecutive days. The number of activities you report are based on the size of your practice:
- Groups with over 15: Attest to 2 high-weighted IAs; OR 1 high-weighted and 2 medium-weighted IAs; OR 4 medium-weighted IAs;
- Solo clinicians and groups with 15 or less: Attest to 1 high-weighted IA OR 2 medium weighted IAs.
More information on the Improvement Activities, and how to attest to this category in your MDinteractive account, can be found here.
Cost -This category is worth a maximum of 15 points. CMS will use Medicare claims data to calculate the Cost performance score, so you do not need to submit separate data for this category.
STEP 4: Begin your reporting.
MDinteractive provides one-stop shopping for submitting Quality, Promoting Interoperability, and Improvement Activity data to CMS to fulfill your MIPS requirements. We support all 2019 MIPS categories and measures, whether you are reporting as an individual or a group. We also offer unlimited customer support, via phone, live chat and email, to assist you throughout the entire reporting process.
You can create a free account here or log into an existing account from our website to report 1 or more MIPS categories.
Completing your MIPS Reporting
Whether you are just trying to avoid the 7% penalty or you are seeking to maximize your Medicare payments, our MIPS Reporting Checklist walks you through the key steps you can take to get started and successfully complete your reporting. At MDinteractive, we strive to make your reporting quick and easy so you can fulfill your MIPS requirements and protect your Medicare payments. Contact one of our MIPS specialists today if you have any questions.
2019 MIPS Reporting MIPS Checklist MIPS Performance Categories