Who are the MIPS-eligible clinicians?
Clinicians can now use an interactive tool to determine if they should participate in the Merit-based Incentive Payment System (MIPS) for 2017. To determine your status, enter your national provider identifier (NPI) into the entry field on the tool.
CMS has proposed that a MIPS-eligible clinician be defined as the following licensed providers and any group that includes such professionals:
- Doctors of Medicine (MD)
- Doctors of Osteopathy (DO)
- Doctors of Dental Surgery/Dental Medicine (DMD/DDS)
- Doctors of Podiatry
- Doctors of Optometry
- Physician Assistants (PA)
- Nurse Practitioners (NP)
- Clinical Nurse Specialists
- Certified Registered Nurse Anesthetists
After three years of MACRA, the US Secretary of Health and Human Services has the option to expand the definition of a MIPS eligible clinicians to also include:
- Physical Therapists
- Occupational Therapists
- Speech/Language Pathologists
- Nurse Midwives
- Clinical Social Workers
- Clinical Psychologists
- Dietitians & Nutritional Professionals
Clinicians who will not participate in MIPS:
- Clinicians newly enrolled in Medicare
- Clinicians below the low-volume threshold: Medicare Part B-allowed charges less than or equal to $30K/year OR those who see 100 or fewer Medicare Part B patients per year.
- Clinicians significantly participating in Advanced APMs