MIPS Performance Categories
Each clinician or group will have a MIPS composite performance score (CPS) which will factor in performance in 4 weighted performance categories on a 0-100 point scale. The four performance categories include:
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50% of total score |
This category replaced the PQRS program.
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25% of total score |
This category replaced the EHR Meaningful Use.
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15% of total score |
This measure rewards clinical practice improvements, such as activities focused on care coordination, beneficiary engagement, and patient safety (e.g.,expanded practice access, such as same-day appointments for urgent needs).
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10% of total score |
This category has no reporting requirements for clinicians. This will be calculated by CMS based on claims submitted. |
MIPS Payment Adjustments
The four performance category scores (Quality, Advancing Care Information, Improvement Activities and Cost) would be aggregated into a MIPS composite performance score (CPS). The MIPS CPS will be used to calculate a positive, negative or neutral adjustment to clinicians’ Medicare Part B payments. Payment adjustments would be based on the relationship between a clinician’s CPS and a MIPS performance threshold.
- MIPS clinicians can receive neutral, positive or negative payment adjustments in 2020. Eligible clinicians with less than 15 MIPS points will receive up to a 5% penalty in 2020.
- A score above 15 MIPS points will yield a positive payment adjustment based on the amount of penalties collected from clinicians with scores below 15 (MIPS is budget neutral program)
- An additional bonus will be applied to payments to high performers with scores above 70 MIPS points.
Further information can be found at: