7. Is the low-volume threshold based on what was billed / number of patients seen in 2022, or will it be 2023? CMS conducts two eligibility determination periods: The first eligibility determination period uses the 12 months of data from October 1, 2021 – September 30, 2022 with a 60-day claims run out. CMS will run a second eligibility determination for those groups and clinicians that did not meet the low-volume threshold during the first period, and will use data from October 1, 2021 – September 30, 2023 with a 60-day claims run out. Both periods apply to the 2023 reporting year. Additionally, if you are exempt based on the first eligibility determination period, CMS will not change your status based on the second eligibility determination period. Pages MIPS Participation Eligibility and Exclusions1. How will the low volume exclusion be determined – at the individual or the group level?2. Is the low-volume threshold for allowed charges or Medicare paid amount?3. Are physicians and other eligible clinicians who practice in Federally Qualified Health Centers (FQHCs) and Community Health Centers (CHCs) exempt from MIPS?4. For the purposes of the MIPS exemption, does the low-volume threshold apply to Medicare Advantage patients too?5. When will CMS notify individuals who are exempt in 2023?6. Even if I am exempt from MIPS participation, can I still report? If so, am I eligible for / subject to an adjustment? What are the pros and cons of reporting if exempt?7. Is the low-volume threshold based on what was billed / number of patients seen in 2022, or will it be 2023?8. If we are a group of 4 physicians and as a group TIN we do not meet the low volume qualifications, but individually we all qualify as low volume, can we elect to report individually and avoid MIPS?9. What happens if I change practices? Comments are closed.
