Top Ten MIPS Changes from 2017 to 2018 Part 1


The Quality Reporting Engagement Group recently reported on their top 10 differences in MIPS (Merit-based Incentive Payment System) reporting from 2017 to 2018.  Presented below are numbers 1 – 5.

1.  Low Volume Threshold

In 2017, eligible clinicians were excluded from reporting if they had less than $30,000 in Medicare Part B allowed charges, including service and drugs, OR they provided care to less than 100 Medicare Part B beneficiaries.

In 2018, eligible professionals are excluded if they have $90,000 or less in Medicare Part B charges OR provide care to less than 200 Medicare Part B beneficiaries.

2. Payment Adjustment Range

Under MIPS, the payment adjustment range for performance changes from +/- 4% in 2017 to +/- 5% in 2018.

3. MIPS Performance Threshold

In 2017, the performance threshold was set at 3 points (scoring a minimum of three points would prevent a negative payment adjustment). In 2018, the performance threshold increased to 15 points. In both years, the additional performance threshold stays at 70 points for exceptional performance.

4. Reporting Options

In 2017, you had the option of reporting as an Individual (eligible clinician) or with a Group. In 2018, the individual and group options remained, but a third Virtual Group was added. A Virtual Group could be made up of 10 or fewer eligible clinicians who came together virtually to report. Practices or individuals had to elect to be part of a virtual group before the end of 2017 for the 2018 reporting year.

5. Final Score Breakdown

The performance category scores changed in the years 2017 and 2018.
Quality: 60% in 2017, 50% in 2018
Cost: 0%, 10%
Improvement Activities: 15%, 15%
Advancing Care Information: 25%, 25%
*CMS recently changed the name of the Advancing Care category to Promoting Interoperability.

Our Quality Reporting Engagement Group can assist your practice with your value-based care needs. For more information, email us at or call 877.570.8721, x2.