2022 MIPS Guide - Merit Based Incentive Payment System

MIPS Guide 2022

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) established the Medicare Quality Payment Program (QPP) to reward good value and low-cost treatment. As per the 2022 MIPS guide, Eligible clinicians choose one of two payment tracks annually: 

  1. Merit Based Incentive Payment System (MIPS) and
  2. Advance alternate payment model (APM). 

What is MIPS?

MIPS (merit based incentive payment system) is the program that will determine Medicare payment adjustments. ECs (eligible clinicians) may receive a payment bonus, penalty, or no payment adjustment using a composite performance score.

MIPS keeps paying qualifying clinicians on a fee-for-service basis while also requiring them to report PI (Promoting Interoperability), IA (Improvement Activities), and quality data. MIPS consultant ensures the practice performance under the designated compliance of MIPS parameters. Clinicians are assessed on their performance compared to other clinicians across the states at the end of each performance year. Their Medicare Part B payments are adjusted positively, neutrally, or negatively each two years later. Payments in 2024, for example, will be influenced by performance in 2022. Payment adjustments for the fiscal year 2022 may vary from -9 to +9%. 

MIPS Participation Option

Clinicians can participate as either individuals or in groups. All ECs reporting within the TIN (tax identification number) must be included in the group’s reporting when reporting as a group. Each “NPI” (national provider identifier) within the TIN will receive a MIPS final score. A TIN cannot be split into several groups.

Important: For a given performance year, the decision to report individually or as a group applies to all MIPS categories. In some categories, a clinician cannot opt to report as an individual while reporting as a group in others. Whether to report as a group or by individual clinicians has financial and reputational ramifications that must consider.

2022 MIPS Reporting Performance Categories

MIPS annually assigns a 100-point performance scale to eligible Medicare Part B clinicians, resulting in a Composite Performance Score (CPS). The payment adjustment will base on the Composite Performance Score, calculated using the reported measures and categories.

There are four scalable categories of MIPS,

  • Quality 
  • Promoting Interoperability 
  • Cost 
  • Improvement Activities

Note: These percentage weights are designed for the 2022 performance period.

1. Quality (30%) 

2. Promoting Interoperability (25%)

3. Cost (30%)

4. Improvement Activities (15%)

MIPS reporting requirements are the same for all specializations. That’s why NEO MD CMS Certified Registry of MIPS consultants work with a variety of practices to help them provide—and report on—the best quality of care measures, regardless of their EHR and PM platforms.YOU CAN REACH US for MIPS consulting services at (registry@neomdinc.com) or (929) 502-3636.