This article is a part of the January/February 2022, Volume 34, Number 1, Audiology Today issue.
This article provides an overview of the Merit-Based Incentive Payment System (MIPS) program, current participation requirements, and policy changes included in the Final Calendar Year (CY) 2022 Medicare Physician Fee Schedule (PFS) Rule.
MIPS represents one option for participation under the Medicare Quality Payment Program (QPP). The other option, which is not discussed in this article, is participation via Advanced Alternative Payment Models.
MIPS will be the pathway most familiar to audiologists, as it retains some of the quality measures audiologists once reported under the former Physician Quality Reporting System (PQRS). MIPS reporting only applies to claims submitted to Medicare.
What Is the Merit-Based Incentive Payment System?
The Merit-Based Incentive Payment System (MIPS) is the result of the consolidation of three former Medicare quality reporting programs: the Physician Quality Reporting System (PQRS), the Value-Based Payment Modifier (VBPM), and Meaningful Use (MU). MIPS also includes an Improvement Activities category. MIPS ties payment incentives and payment penalties to defined quality, cost savings, electronic data exchange, and clinical improvement activities. Audiologists are currently measured by just two metrics: quality and clinical improvement.
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