CMS Releases MIPS “Special Status” Information

The Centers for Medicare & Medicaid Services have updated their eligibility tool to include “special status” for the Merit-based Incentive Payment System (MIPS). Special status refers to patient facing and hospital-based clinicians, as well as those considered a small or rural practice and/or in a Health Professional Shortage Area (HPSA).

Physician anesthesiologists may look up their patient facing and hospital-based status by looking up their National Provider Identifier (NPI) in the tool. To learn more about how special statuses are determined, visit the Quality Payment Program (QPP) website here.

MIPS eligible clinicians (ECs) that are considered hospital-based or non-patient facing are exempt from the Advancing Care Information (ACI) component. For these ECs, the Quality component will account for 85% of the total MIPS score and Improvement Activities will remain at 15%.

Both hospital-based and non-patient facing ECs are required to perform and attest to 40 points worth of Improvement Activities for at least 90 consecutive days during the performance period. For hospital-based ECs each medium-weighted activity equals 10 points, and each high-weighted activity equals 20 points. For non-patient facing ECs, activities are doubly weighted, so each medium-weighted activity equals 20 points and each high-weighted activity equals 40 points.

Regardless of patient facing and hospital-based status, all ECs are required to report six quality measures, including one outcome or other high-priority measure if an outcome measure does not apply.

For more information on MACRA eligibility and requirements, please visit ASA MACRA resources link and the Quality Payment Program website. Please submit any questions you may have to [email protected] or call 202-289-2222.