2021 Final MIPS Eligibility and 2022 Initial MIPS Eligibility Information Now Available

The Centers for Medicare and Medicaid Services (CMS) announced this week that the final 2021 Merit-based Incentive Payment System (MIPS) eligibility status information is now available via the Quality Payment Program (QPP) Participation Status Tool. Clinicians and groups will also be able to review their initial eligibility status for MIPS in 2022 with the participation status tool. 

CMS made its updates to eligibility based on Medicare data it collected from the second segment of the MIPS Eligibility Determination Period ranging from October 1, 2020 to September 30, 2021. According to CMS’ low-volume threshold, clinicians and their groups do not meet the eligibility requirements if they:

• Billed $90,000 or less in Medicare Part B allowed charges for covered professional services during either of the 2 segments of the MIPS Eligibility Determination Period (October 1, 2019 – September 30, 2020, or October 1, 2020 – September 30, 2021); OR 
• Provided care to 200 or fewer Part B-enrolled patients during either of the 2 segments of the MIPS Eligibility Determination Period; OR 
• Provided 200 or fewer covered professional services to Part B patients during either of the 2 segments of the MIPS Eligibility Determination Period.

ASA encourages any member currently participating or seeking to participate in MIPS to access the QPP Participation Status Tool to check for any changes to their group’s eligibility. Some clinicians and groups who do not meet all of the eligibility requirements will be labeled “opt-in eligible” and will then be able to opt-in to MIPS, which includes a payment adjustment. All clinicians and groups who are not eligible also have the option to voluntarily report data to MIPS without a payment adjustment. Clinicians and groups can sign up for either of these options on the QPP website (opt-in submissions for 2021 will be accepted starting January 3, 2022).

For more information on MIPS, visit ASA’s resource web page or CMS’ overview of MIPS participation options.

To contact CMS with any questions on MIPS eligibility, the Quality Payment Program can be reached at 1-866-288-8292 (Monday-Friday 8 a.m. - 8 p.m. ET) or by e-mail at: [email protected]

Please contact the Anesthesia Quality Institute at [email protected] or the ASA Department of Quality and Regulatory Affairs at [email protected] with any further questions.