Medicare QPP

Physicians Advocacy Institute

Frequently Asked Questions Updated for 2023

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9. What happens if I change practices?

  1. If you change practices after the completion of a performance year but before the payment adjustment year and begin billing under a new tax identification number (TIN), CMS will carry your performance year score and related payment adjustment forward to your new practice; you would not receive the payment adjustment of your new practice for that payment adjustment year. Thus, CMS will look at your old NPI/TIN performance year data and apply that performance score and adjustment to your new NPI/TIN combination. Your performance with the new practice during the performance year will then be used to assess your payment adjustment for the corresponding payment adjustment year.

    For example, if you are part of a new practice in 2023, your payment adjustment will be based on your previous 2021 performance year data and score. Your performance in 2023 with the new practice will then be used to determine your payment adjustment for 2025.
     
  2. What if I am planning to retire in a few years? Should I still participate in MIPS?Participation in MIPS for 2023 will determine payment adjustments beginning January 1, 2025, and this two-year look back for payment adjustments continues for the duration of the program (2024 participation will be used for the 2026 payment adjustment; 2025 performance for the 2027 payment adjustment, etc.). This timeline can be considered as a determining factor for participation.



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