News & Press: Quality Improvement

U.S. Clinicians - Determine Your MIPS Participation Status - You May Not Be Evaluated in 2017

Friday, May 19, 2017  
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Unsure of your participation status in the Merit-based Incentive Payment System (MIPS)? MIPS is an important part of the new  Quality Payment Program. Clinicians can now use an interactive tool on the U.S. Centers for Medicare & Medicaid Services’ Quality Payment Program website to determine if they should participate in 2017. An updated formula has been applied to make estimates of providers' Medicare revenue, which has changed the final participation numbers. This means that you may not be evaluated in 2017.

To determine your status, enter your national provider identifier (NPI) into the entry field on the tool that can be found on the Quality Payment Program website at https://qpp.cms.gov/. Information will then be provided on whether or not you should participate in MIPS this year and where to find resources. 

Participation Criteria

You will participate in MIPS in 2017 if you:

  • Bill Medicare Part B more than $30,000 per year AND
  • See more than 100 Medicare patients per year.

You must also be a:

  • Physician
  • Physician assistant
  • Nurse practitioner
  • Clinical nurse specialist
  • Certified nurse practitioner

If you are new to Medicare in 2017, you do not participate in MIPS. You may also be exempt if you qualify for one of the special rules for certain types of clinicians or are participating in an Advanced Alternative Payment Model (APM). To learn more, review the MIPS Participation Fact Sheet.

If you are not in the program in 2017, you can participate voluntarily and you will not be subject to payment adjustments.

Participation Notification Letters

CMS is reviewing claims and letting practices know which clinicians need to take part in MIPS. The Medicare Administrative Contractor that processes Medicare Part B claims recently sent letters in the mail notifying clinicians of their MIPS participation status. This letter will tell the participation status of each MIPS clinician associated with the Taxpayer Identification Number or TIN in a practice. See a sample of the letter (zip) on the Education page of https://qpp.cms.gov/. This tool is another resource for clinicians to use to determine their status.

For More Information

To get the latest information, visit the Quality Payment Program website. The Quality Payment Program Service Center may be reached at 1-866-288-8292 (TTY 1-877-715- 6222), available Monday through Friday, 8:00 AM-8:00 PM ET or via email at QPP@cms.hhs.gov.


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