MACRA QPP Center

Physicians Advocacy Institute

Frequently Asked Questions Updated for 2020

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1. What happens if I choose not to report any data to MIPS?

  1. Unless you qualify for an exemption from MIPS in 2020, you will receive a -9% payment adjustment to your Medicare Part B fee-for-service (FFS) claims in 2022.
     
    The following eligible clinicians are exempt from participation in MIPS:
    • Newly-enrolled Medicare eligible clinicians who enroll in Medicare for the first time during the performance year
    • Eligible clinicians and groups that are below the low-volume threshold:
      • Who have Medicare Part B allowed charges ≤ $90,000
        AND
      • Who provide care to 200 or fewer Medicare Part B patients; AND,
      • Provide 200 or fewer covered professional services to Part B patients

      Use the CMS NPI lookup tool to help you determine your eligibility. To use the tool, you will need to know your 10-digit national provider identification (NPI) number.
       
    • Eligible clinicians who are participating in Advanced APMs



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