A new interactive tool released by the Centers for Medicare & Medicaid Services (CMS) will help clinicians determine whether they are required to participate in the merit-based incentive payment system (MIPS) in 2017.

To determine their status, clinicians must enter their national provider identifier into the tool. Qualifying clinicians — including physicians, physician assistants, nurse practitioners, clinical nurse specialists, and certified nurse practitioners — need to submit data to MIPS if they:

  • bill Medicare Part B more than $30,000 annually; and
  • see more than 100 Medicare patients each year.

Clinicians are exempt from submitting data if they:

  • are new to Medicare in 2017;
  • qualify for a special rule, applicable to certain types of clinicians; or
  • participate in an alternative payment model.

Clinicians who are not in the program in 2017 can participate voluntarily; they will not be subject to payment adjustments.

CMS recently sent letters by mail notifying clinicians of their MIPS participation status. For more information on who qualifies, see CMS’ MIPS Participation Fact Sheet.

America’s Essential Hospitals has established a resource page dedicated to quality payment programs. Visit this page regularly for new and updated information.

Contact Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.