Clinicians can now use the updated Participation Lookup Tool from the Centers for Medicare & Medicaid Services (CMS) to check their 2018 eligibility for the Merit-Based Incentive Payment System (MIPS) under the Quality Payment Program (QPP). Within the online tool, clinicians can enter their National Provider Identifier (NPI) to find out whether or not they need to participate in MIPS during the 2018 performance year.

What’s Different in 2018?

To reduce the burden on small practices, CMS changed the MIPS eligibility low-volume threshold. Clinicians and groups are now excluded from MIPS if they bill $90,000 or less in Medicare Part B allowed charges for covered services under the Physician Fee Schedule (PFS). They are also excluded if they have provided covered services to 200 or fewer Part B beneficiaries. Therefore, clinicians and groups who bill more than $90,000 in Part B allowed charges and who provide covered services to more than 200 Part B beneficiaries are included in MIPS for the 2018 performance period.

Note: In 2018, CMS will not send letters to physicians by mail informing them of their MIPS eligibility status (which the agency did in 2017). The only way to learn 2018 MIPS status is through the Participation Lookup Tool on qpp.cms.gov. CMS intends update the QPP interactive website in early Summer 2018.

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

Find out if you’re eligible for MIPS.