2024 MIPS Updates: What You Need to Know
New changes to the Quality Payment Program’s (QPP) Merit-based Incentive Payment System (MIPS) may impact how you manage your practice and its billing processes.
The MIPS categories — quality, cost, promoting interoperability, and improvement activities — will remain the same for calendar year 2023, but each category includes updates that were issued in the Centers for Medicare and Medicaid Services (CMS) final rule.
Here, we’ll review some of the key changes that may impact ModMedⓇ clients.
MIPS Final Rule Updates
While there are a number of detailed changes to program measures, there are also a few key changes that may apply to your practice more broadly:
- In order to avoid a penalty of up to 9%, physicians must submit a score of at least 75 out of 100 points. If you submit a score of less than 75, it will impact your reimbursements in 2025.
- Calendar year 2023 is the first year that eliminates the exceptional performer bonus. It may still be possible to get a positive payment adjustment, but it is no longer considered a bonus.
- If you choose to report a MIPS Value Pathway (MVP), you’ll need to register with CMS between April and November 2023.
Take the time to prepare your practice for upcoming changes now. ModMed clients can sign up for our MIPS Advisory services to get extra MIPS support.
Quality
There are several changes to the quality category for calendar year 2023.
The first is that CMS added nine new measures and removed 11 measures. For many ModMed clients, relevant changes relate to immunization status: The flu and pneumonia measures are being removed for traditional MIPS but staying around for some MVPs.
How some of these measures are scored is also changing. Participants can now earn less than three points for measures with a benchmark. Prior to 2023, participants could not earn less than three points per measure, if they met the data completeness requirement and the case minimum of 20 patients. That is no longer the case. You can now earn between one and 10 points for these measures depending on your practice size. Additionally, you may receive zero points for measures without a benchmark or case minimum not met, depending on your practice size.
Additionally, for 2023, data completeness must be at >70%, and will be increasing to 75% for 2025.
For more information, watch our webinar.
Cost
Many physicians have not been scored on cost for the past few years due to COVID-19; however, CMS has stated that it will score the Cost category for 2022 with final cost scores likely to be available by late summer 2023.
For more information, watch our webinar.
Promoting Interoperability
One important requirement for this year is that your EHR must be certified to the 2015 Edition Cures Update for the 2023 performance period, and you will need your certified ID when you are ready to submit your 2023 Promoting Interoperability (PI) measures for MIPS.
We are pleased to confirm that we have met all the necessary requirements, and both ModMed’s EMA and gGastro EHRs are certified to the 2015 Edition Cures Update.
One other important change: the query of prescription drug monitoring program measure is now required in 2023 and CMS changed it to include schedule 2, 3 and 4 drugs. However CMS has stated that you can claim an exclusion if you write less than 100 permissible prescriptions.
For more information, watch our webinar.
Improvement Activities
For calendar year 2023, improvement activities are only subject to minor changes. CMS is adding four new activities, modifying five activities, and removing five activities. Of the new activities, high priority is given to creating and implementing language access plans, as well as plans to improve care for LGBTQ patients.
For more information, watch our webinar.
Managing Change
ModMed makes these MIPS updates easier on your practice with an up-to-date MIPS dashboard, automated MIPS measure tracking and our MIPS Advisory Service.
For more information on how CMS’ MIPS final rule may impact your practice, watch our 2023 MIPS Changes: Prepare Your Practice webinar.
This blog is intended for informational purposes only and does not constitute legal or medical advice. Please consult with your legal counsel and other qualified advisors to ensure compliance with applicable laws, regulations and standards.
