MIPS archive
MIPS 2022 program highlights
Eligible clinicians
Revised the definition of a MIPS eligible clinician to include:
Clinical social workers
Certified nurse mid-wives
Eligibility criteria
The low volume threshold remains the same as 2021 and includes three aspects of covered professional services:
Allowed charges
Number of Medicare patients who receive services
Number of services provided
You must participate in MIPS (unless otherwise exempt) if, in both 12-month segments of the MIPS Determination Period, you:
Bill more than $90,000 for Part B covered professional services, and
See more than 200 Part B patients, and;
Provide 200 or more covered professional services to Part B patients.
The opt-in policy also remains the same. It allows physicians or groups who meet one or two of the low-volume threshold criteria to opt-in to participate in MIPS and receive a final score and payment adjustment.
Payment adjustment
The 2022 performance period payment adjustment (penalty or incentive) is 9% applied to reimbursements in 2024.
Minimum threshold
Minimum points needed to avoid penalty: 75 points
Up 15 points from 2021 (60 points)
Maximum threshold
Minimum points needed for getting an incentive: 89 points
Up 4 points from 2021 (85 points)
MIPS category breakdowns
Quality: 30% of MIPS score
10% decrease in category weight from 2021 (40%)
Total of 200 quality measures available for the 2022 performance period
New policy for scoring new measures without a benchmark:
In the first year in MIPS, there will be a 7-point scoring floor (you’ll receive 7 to 10 points)
In the second year in MIPS, there will be a 5-point scoring floor (you’ll receive 5 to 10 points)
Data completeness remains at 70%
Small practices (15 providers or fewer) receive 3 points for not meeting data completeness. Note: This will be removed in the 2023 performance year.
Large practices (16 providers or more) receive 0 points for not meeting data completeness
Performance period: Jan. 1 – Dec. 31, 2022
Submission methods: claims (for small practices), registry, QCDRs such as the Academy's DataDermTM, and EHRs
6 bonus points added to quality category for small practices (15 providers or fewer)
Removed end-to-end electronic reporting and high priority/outcome measure bonus points (except the one high priority/outcome measure that is required)
Improvement Activities: 15% of MIPS score
No change in category weight from 2021
Medium- and high-weighted activities available
Added new improvement activities about health equity and standardizing language related to equity across the improvement activities inventory
Added 7 activities related to promoting health equity, modified 15, and removed 6
Group participation threshold remains the same as 2021 (50% of participation of eligible clinicians in group)
Performance period: 90-day continuous performance period between Jan. 1 – Dec. 31, 2022
Participating clinicians do not have to perform activity at the same time
Submission methods: CMS or QCDR
Promoting Interoperability: 25% of MIPS score
No change in category weight from 2021
2015 CEHRT required (Certified EHR Technology)
Performance period: continuous 90-days between Jan. 1 – Dec. 31, 2022
Submission methods: registry, QCDRs, EHRs
Modified the reporting requirements for the Public Health and Clinical Data Exchange objective and requiring MIPS eligible clinicians to report the following two measures (unless an exclusion can be claimed):
Immunization Registry Reporting
Electronic Case Reporting
The following measures are optional; clinicians, groups and virtual groups that report a “yes” response for any of these measures will earn 5 bonus points and all three exclusions for each of these are removed:
Public Health Registry Reporting measure
Clinical Data Registry Reporting measure
Syndromic Surveillance Reporting measure
Note: Reporting more than one of these optional measures won’t result in more than 5 bonus points
New required measure, but not scored
SAFER Guides Measure under the Protect Patient Health Information Objective
MIPS ECs must attest to having conducted an annual self-assessment using the High Priority Practice Guide with one "yes/no" attestation statement accounting for the complete self-assessment using the Guide
Modified the required Prevention of Information Blocking attestation statements.
Hardship exemption available in late 2022
Cost: 30% of MIPS score
10% increase from 2021 (20%)
No action required by eligible clinician
5 new episode-based cost measures:
2 procedural measures: Melanoma Resection, and Colon and Rectal Resection
1 acute inpatient measure: Sepsis
2 chronic condition measures: Diabetes, and Asthma/Chronic Obstructive Pulmonary Disease [COPD]
The 5 new episode-based cost measures have the following case minimums (calculated using administrative claims data): o Asthma/COPD: 20 episodes o Colon and Rectal Resection: 20 episodes o Diabetes: 20 episodes o Melanoma Resection: 10 episodes o Sepsis: 20 episodes
Scoring
The overall scoring for each category remains the same as 2021 methodology.
Reporting Type
Group vs individual reporting available .
Individual: Under an NPI number and TIN where they reassign benefits; report via claims, registry, or EHR
Group: Two or more clinicians (by NPIs) who have reassigned their billing rights to a single TIN; report via claims, registry, or EHR
Beginning in 2022, small practices, excluding those participating in MIPS as part of a virtual group, must submit data as a group in any performance category to indicate that they wish to be scored as a group for Medicare Part B claims.
Small Practice Accommodations
Accommodations for small practices include:
3 points for measures that do not meet data completeness of 70%
Claims reporting available
6 bonus points added to numerator of quality category
Automatic redistribution of the Promoting Interoperability performance category weight for any small practice that does not submit data for the performance category
When PI is redistributed, quality will be 40%, cost 30%, and improvement activity 30%
When PI and cost are both reweighted, quality will be 50% and improvement activity 50%
