Reminder: 2020 MIPS performance year data submission window closes March 31, 2021. For more information please visit the QPP website.
Reminder: 2020 MIPS Extreme and Uncontrollable Circumstances Exception Application Deadline was extended to February 1, 2021. If you have any concerns about the effect of the COVID-19 pandemic on your performance data, including cost measures, for the 2020 performance period, submit an application now and be sure to cite COVID-19 as the reason for your application.
2020 MIPS Participation Criteria
Clinicians and groups are ELIGIBLE for 2020 MIPS if they exceed ALL 3 criteria below, otherwise they are excluded from 2020 MIPS:
- Billed $90,000 or less in Medicare Part B allowed charges for covered professional services during either of the 2 determination periods (October 1, 2018 – September 30, 2019 or October 1, 2019 – September 30, 2020); OR
- Provided care to 200 or fewer Part B-enrolled patients during either of the 2 determination periods; OR
- Provided 200 or fewer covered professional services professional services to Part B patients during either of the 2 determination periods.
Check the Quality Payment Program (QPP) Participation Status Tool to view your final 2020 eligibility status for MIPS.
Participating Through the Opt-In or Voluntary Reporting Options
Clinicians and groups who are not eligible for 2020 MIPS (meaning they did not exceed ALL 3 low-volume threshold criteria about) can still choose to report data to MIPS.
If your 2020 eligibility status says “opt-in eligible” this means you have exceeded 1 or 2 of the low-volume threshold criteria noted above and have at least 1 clinician who:
- Is identified as a MIPS eligible clinician type on Medicare Part B claims;
- Enrolled in Medicare before 2020;
- Is not a QP; and
- Is not a participant in one or more MIPS APM entities, all of which are below the low-volume threshold.
Here’s what you can do:
- Opt-in to MIPS: You will receive a MIPS payment adjustment (positive, negative or neutral).
- Voluntarily Report: You will not receive a MIPS payment adjustment.
- Note: Once made, your election is binding and irreversible. (No election is required if you don’t want to report data to MIPS.)
NOT Opt-in Eligible
If you are NOT opt-in eligible, you are excluded from MIPS because you fall below all 3 of the low-volume threshold criteria. You may choose to voluntarily report (no election required) data to MIPS and will not receive a MIPS payment adjustment.
Elect to Opt-in
Opt-in eligible clinicians and groups need to complete an election to opt-in or voluntarily report in MIPS by signing in to qpp.cms.gov before reporting any data.
For More Information
- Reporting Options Overview Webpage
- Quality Payment Program
- What Happens if I Elect to Opt-in to MIPS?
- 2020 MIPS Opt-In Reporting and Election Process Toolkit
Contact the Quality Payment Program at QPP@cms.hhs.gov or 1-866-288-8292. To receive assistance more quickly, consider calling during non-peak hours—before 10 a.m. and after 2 p.m. ET.
Customers who are hearing impaired can dial 711 to be connected to a TRS Communications Assistant.