MIPS Eligibility Letters – Is Your Address Correct?

April 18, 2017

Written by Brandi Wahlen

Are you wondering whether you need to participate in the Merit-based Incentive Payment System (MIPS) this year? Good news! Centers for Medicare & Medicaid Services (CMS) will be sending each clinic a letter listing your eligibility by Taxpayer Identification Number (TIN) and all the National Provider Identifiers (NPI) in your group.

For the 2017 performance year, there are three exemptions from MIPS:

1. Clinicians in their first year of Medicare Part B participation
2. Clinicians billing Medicare Part B up to $30,000 in allowable charges or providing care for less than 100 Part B patients in one year
3. Clinicians participating in an Advanced Alternative Payment Model (APM)

It is very important you verify that all the information in the Medicare Provider Enrollment, Chain and Ownership System (PECOS) is correct. These letters will be mailed to the mailing address associated with the TIN number on file in PECOS. If this is incorrect, you will not receive your letter, which will make it difficult to determine whether your providers are eligible. Please visit the PECOS webpage to view tutorials and update any incorrect information. Remember: You have to do this with each provider who is billing under the facility TIN.

Mountain-Pacific Quality Health supports practices to actively and successfully participate in MIPS to avoid penalties and possibly earn positive adjustments. We offer

• services in all MIPS categories,
• resources to help meet program requirements,
• access to Quality Payment Program experts who can answer your tough questions.

Please contact us at qualitypaymenthelp@mpqhf.org with your MIPS questions and assistance needs.

Leave a reply, ask a question or share information using the “Leave a Reply” section below, or email Sharon Phelps directly with your questions or comments.

Other Resource Links
CMS QPP Website
HTS MIPS Services
See all Previous MIPS blogs

 

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