MIPS Eligibility and Participation Facility-based Scoring in MIPS reporting

QPP MIPS as an experienced qualified registry gives a generalized view of MIPS eligibility and participation options. Program. This QPP program has two frameworks; one of them is MIPS reporting. It provides physicians with a framework to get reimbursements using a pay-per-performance model.

It is CMS that finalizes everything related to the upcoming MIPS performance year. Alongside this, it manages the activities of the previous program as well. Every year MIPS reporting gives an invitation to all clinicians who fall under the MIPS eligibility criteria. CMS usually updates it every year. A provider must be aware of all the processes of MIPS and have updated information. Otherwise, their MIPS performance can have an effect. They must stick to the provided guidelines and compete at the same time. Here, QPP MIPS is sharing a generalized overview of MIPS eligibility and participation options. Let’s just dig in!

Your MIPS Eligibility is Must!

MIPS reporting is a program for Medicare providers only. Not everyone can take part in reporting. That’s why CMS approves a list of eligible clinicians in its PFS final rule. Although the tentative list comes a long time before the final rule launches. Thus, those who have eligibility for MIPS reporting, already start preparing themselves for challenges before entering the relevant PY. And as long as they retain their eligibility, they get MIPS final score and payment adjustments resultantly. However, if they do not retain their eligibility till the end of the Performance Year, CMS does not give them any incentive at all. General Surgery Billing Services

Participation Options; How to be a Part of MIPS?

Every eligible clinician in MIPS reporting has several reporting options in their hand. Therefore, they have to be selective while picking a participation option. Following the participation options in the MIPS reporting framework for clinicians;

● Individual Clinician

● Group

● Virtual Group

● APM Entities

The providers have their own Tax Identification Number (TIN) or National Provider Identifier (NPI). Thus, MIPS reporting is the passage by which CMS evaluates the performance of every TIN/NPI. However, it is quite common for providers to attach their NPI with more than one organization. In such a scenario, MIPS reporting eligibility forms the base on their unique TIN/NPI combination. Similarly, CMS instructs clinicians to satisfy the MIPS requirement in every separate practice they do.

Special Status Option for MIPS Participants

Special statuses are a kind of relaxation or flexibility by the CMS side for MIPS reporting. Not every provider can get a special status in MIPS reporting. CMS has provided comprehensive details for this purpose. The special statuses holder falls into different categories of MIPS such as

● Hospital-based facilities,

● Small practices

● and rural areas, etc.

You might be thinking, what changes for special status holders in MIPS reporting? Are they going to get some sort of special treatment for MIPS? If you are thinking so then, yes, they get it. The MIPS framework is the same for them but CMS gives them relaxation of minimized reporting requirements.

Now, there is another query regarding the special status of MIPS participation. Yup, you are going right if you are thinking about how we will get to know about our status. How to check this special status?
One simple way for checking the participation status is the ‘QPP Participation Status Tool’. You can enter your NPI in the searching area and get updates on your MIPS reporting status.

What is Facility-based Scoring in MIPS reporting?

Those clinicians who get the ‘facility-based’ status will get their facility-based scoring. The facility-based participants are usually awarded a Hospital Value-Based Purchasing (VBP) score. Thus, CMS counts on this score and replaces it with MIPS final scores itself only if the score is more favorable than their combined scores in the Quality and Cost category. This policy of MIPS reporting just reduces the reporting burden of these clinicians. Neurology Billing Services

Conclusion

MIPS eligibility is something else that every clinician must have to retain throughout their performance period. CMS determines the clinicians' eligibility twice a year. One time is the first snapshot, and the second time is the second snapshot. After that, they get the MIPS final scores next year till August. QPP MIPS as a qualified registry offers MIPS consulting services to all providers to help them retain their eligibility in MIPS reporting.

QPP MIPS Reporting Services