MIPS – Merit-based Incentive Payment System

‘MIPS’ is a payment track under the ‘Quality Payment Program’ where eligible clinicians can earn a performance-based adjustment to their ‘Medicare’ payment.

It streamlines the following three ‘Medicare’ programs

• Value-based Payment Modifier Program
• Physician Quality Reporting System
• Medicare Electronic Health Record Incentive Program (Meaningful Use)

These programs are streamlined in a single payment program along with the addition of a new component called ‘Improvement Activities’.

Under ‘MIPS’, eligible clinicians (ECs) will be scored annually in four performance categories to derive a ‘MIPS’ composite score between 0 and 100.

The four categories are:

• Quality
• Cost
• Promoting Interoperability
• Improvement Activities.

A clinician can choose to participate as an individual or in a group for each NPI/TIN combination that they bill under. CMS will apply the payment adjustment at the individual TIN/NPI level for all MIPS eligible clinicians.

User permissions need to be enabled for MIPS (Quality Programs) module. To see how that is done, click here.