2019 MIPS Requirements

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  • Published date: January 25, 2019
    • Fremont, California, United States


The Merit-based Incentive Payment System was created in Medicare to measure the performance of physicians and others serving Medicare payments in several areas, and adjust payments to those providers based on how they score in the program.

Provides are measured in 4 areas - Quality of Services, Cost of Services, Practice Improvement Activities, and Promoting Interoperability. Each year, providers must submit data to CMS thru various sources. CMS then takes that data and computes scores.

Based on the provider score in relation to a threshold, the provider will either get (for 2019 scores) an increase of up to 7% in their Medicare Fee Schedule for top performers, a smaller increase or no increase for acceptable performance, and a decrease of up to 7% in their fee schedule for those providers below the threshold. Those changes are applied to the 2021 fee schedule.

Why should you Attend: Does a 7% increase in your Medicare reimbursements sound good to you? Does a 7% decrease in your Medicare fees sound bad to you? Either of these situations are possible for 2021 based on your performance in the 2019 MIPS program.

Medicare has issued new guidelines for this year, which impose specific requirements on doctors, physician assistants, CRNAs, physical therapists, occupational therapists, clinical psychologists, audiologists, speech language pathologists, and other providers who see Medicare patients.

Any of these provider types must understand their obligations in the MIPS program to avoid a penalty and perhaps earn incentive payments.

Areas Covered in the Session:

What is MIPS?
Who must Participate?
What Categories are Measured, and how?
What are the Quality Measures?
How is cost Determined?
What are Practice Improvement Activities?
How is data submitted?
How are Scores Calculated?
How are fee Schedule Adjustments made?
How can I improve my Chances of Getting a Positive Adjustment?

Who Will Benefit:
Providers Participating in Medicare
Stanley Nachimson - MentorHealth Speaker Profile
Stanley Nachimson is principal of Nachimson Advisors, a health IT consulting firm dedicated to finding innovative uses for health information technology and encouraging its adoption.

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