MIPS Eligibility Now Available at Group Level
Date of Publication May 10, 2018
Providers may now use the CMS Quality Payment Program (QPP) website to check their groups 2018 eligibility for the Merit-based Incentive Payment System (MIPS).
After logging in using EIDM credentials, browse to the Taxpayer Identification Number (TIN) affiliated with the group, click into a details screen to see the eligibility status of every clinician based on their National Provider Identifier (NPI) and find out whether they need to participate during the 2018 performance year for MIPS.
If you need an EIDM account, refer to the Enterprise Identity Management (EIDM) User Guide
Changes to Low-Volume Threshold
The eligibility threshold was changed for 2018. Clinicians and groups are now excluded from MIPS if they:
• Billed $90,000 or less in Medicare Part B allowed charges for covered professional services under the Physician Fee Schedule (PFS)
• Furnished covered professional services under the PFS to 200 or fewer Medicare Part B -enrolled beneficiaries
This means that to be included in MIPS for the 2018 performance period, providers need to have billed more than $90,000 in Medicare Part B allowed charges for covered professional services under the PFS AND
furnished covered professional services under the PFS to more than 200 Medicare Part B enrolled beneficiaries.
whether the clinicians in your group are eligible for MIPS today. The MIPS Participation Lookup Tool
can also be used see if individual clinicians are eligible for the 2018 performance year without needing to login to the group feature.
Contact the Quality Payment Program by email
or toll free at 1-866-288-8292 (TTY: 1-877-715-6222), if you need help or have questions about using the Quality Payment Program website.