News & Press: Advocacy

US Physicians: Use the MIPS Participation Lookup Tool & Check your 2018 MIPS Eligibility

Monday, April 16, 2018  
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You can now use the updated CMS MIPS Participation Lookup Tool to check on your 2018 eligibility for the Merit-based Incentive Payment System (MIPS).

Just enter your National Provider Identifier, or NPI, to find out whether you need to participate during the 2018 performance year.

Changes to Low-Volume Threshold

To reduce the burden on small practices, the Centers for Medicare and Medicaid Services (CMS) has changed the eligibility threshold 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)

OR

  • 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 you 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.


Note: The 2018 Participation Lookup Tool Update for Alternative Payment Model (APM) participants will be updated at a later time.


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