How to understand if your organization needs to report MIPS in 2017
October 6, 2017
Written by Kristen Schuster, Practice Facilitator
CMS has released a new website allowing providers to look up their National Provider Identifiers (NPI) status to see if they qualify as an Advanced Alternate Payment Model (Advanced APM). Practices must meet a threshold score during the reporting year for Medicare Part B beneficiaries in order to qualify as an Advanced APM, otherwise the practice will have to report to the Merit-Based Incentive Payment System (MIPS). Below you will find how the threshold is calculated and how your practice can use the new CMS tool to identify if your practice is considered an Advanced APM based on claims data from quarter 1. CMS has only calculated practice thresholds from quarter 1 of 2017 and more data will be released later for quarters 2 and 3.
How is this calculated?
• 25% of a practices Medicare Part B payment must be for attributed for CPC+ beneficiaries
• 20% of Medicare Part B patients have been attributed to the CPC+ practice and received professional services
A practice must meet one of the above thresholds during “snapshot” dates. These dates will use data based on claims received.
• March 31st, 2017 (available now)
• June 30th, 2017
• August 30th, 2017
Reminder: Practices need to utilize the Qualifying APM Participant Look-up Tool to check status. CMS will not be notifying practices in any other form.
A CPC+ practice that does not meet one of the threshold dates will not be considered an Advanced APM. This practice will have to report the Advancing Care Information portion of MIPS. If your practice does not meet the threshold, Mountain-Pacific has experts ready to make your first year of reporting successful.
Remember: This is only the claims data from quarter 3. There will be two more snapshot dates available to meet the thresholds to qualify as an Advanced APM.
Also, please refer to the CPC+ Connect to network with other CPC+ practices utilizing the same EHR for ideas and best practices. On the Plus Side is a weekly newsletter, emailed to all subscribers that lists upcoming educational events, CPC+ tasks and links to CMS resources. As always, complete CPC+ information from CMS can be found on the CPC+ Connect Portal. We encourage you to access the portal and check out all available CMS CPC+ resources.
If you have any questions, or run into issues with any of the CPC+ objectives and would like help please use the “Leave a Reply” section below, or email Kristen Schuster directly with your questions or comments.
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