ASRA MIPS Fact Sheets Revised for 2019

Dec 20, 2018

As we move into the third performance year of the Merit-based Incentive Payment System (MIPS), providers should be aware of some changes to the policies as part of the transition process. To aid in your understanding of these changes and how they may affect you, ASRA's Practice Management Committee has developed two fact sheets.  

Under MIPS, Medicare assesses clinician performance in four categories: (1) quality, (2) cost, (3) clinical practice improvement activities, and (4) advancing care information (previously known as “Meaningful Use”). Medicare will adjust an individual clinician's fee-for-service Part B payments in 2020 in a positive, neutral, or negative manner by up to 5 percent.

For the 2019 MIPS performance year, clinicians who earn at least 30 out of a possible 100 points will avoid a negative payment adjustment in 2020. Clinicians who earn more than 30 total MIPS points will be eligible to receive a positive payment adjustment and those earning less than 30 points will receive a negative payment adjustment. Physicians who earn 75 points or more will be eligible for “exceptional” bonus payments. In addition to earning points for performance in each of the MIPS performance categories, physicians also may earn bonus points that count toward their MIPS total performance score through the complex patient bonus for treating patients who are particularly medically complex and relatively low income (Medicare will calculate this bonus without requiring data submission from clinicians).

The fact sheets provide a guide of selected 2019 MIPS quality measures, clinical practice improvement activities, and advancing care information measures, inclusive of the data submission method necessary for each measure or activity.

ASRA has also developed a fact sheet to help explain how MACRA affects Medicare payments to physicians. Download the sheet here.

For more information on MIPS and MACRA generally, please visit Medicare’s Quality Payment Program website


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