CMS Releases Lookup Tool to Help Clinicians Determine MIPS Participation Status

PUBLISHED: May 9, 2017
Source: Centers for Medicare and Medicaid Services
Relevant to: Medical Office/Clinic

The Centers for Medicare and Medicaid Services (CMS) has released a new tool for providers to determine their participation status in the Merit-based Incentive Payment System (MIPS). Clinicians can now use an interactive tool on the CMS Quality Payment Program website to determine if they should participate in the MIPS track of the Quality Payment Program in 2017.

To determine your status, enter your national provider identifier (NPI) into the entry field on the tool which can be found on the Quality Payment Program website at https://qpp.cms.gov/. Information will then be provided on whether or not you should participate in MIPS this year and where to find resources.

Participation Criteria:

Providers will participate in MIPS in 2017 if they are a physician, physician assistant, nurse practitioner clinical nurse specialist, certified nurse practitioner and they:

  • Bill Medicare Part B more than $30,000 a year AND
  • See more than 100 Medicare patients a year.

If a provider is new to Medicare in 2017,he/she will not participate in MIPS. Providers may also be exempt if they qualify for one of the special rules for certain types of clinicians, or are participating in an Advanced Alternative Payment Model (APM).

To learn more, review the MIPS Participation Fact Sheet, a link to which is provided below. CMS recently sent letters in the mail notifying clinicians of their MIPS participation status. Follow the link below to see a sample of that letter under Educational Resources on CMS’s Quality Payment Programs website.

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