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). To determine your status, enter your national provider identifier (NPI) into the entry field on the tool.
Clinicians who will participate in MIPS:
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
- Physical Therapists
- Occupational Therapists
- Speech/Language Pathologists
- 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 $90K/year, those who provide less than or equal to 200 covered professional serviced under the Physician Fee Schedule (PFS), OR those who see 200 or fewer Medicare Part B patients per year.
- Clinicians significantly participating in Advanced APMs
However, beginning in 2019, providers who do not meet at least 1 of the low-volume criteria may choose to opt-in to the MIPS program, submit data, and receive payment adjustments two (2) years after the reporting year.
Assistant Director, Quality Services
Tara Hatfield and Leigh Ann Griffin to lead the board of directors of two Indiana healthcare-related associations. ...