CMS Releases Lookup Tool to Help Clinicians Determine Their MIPS Participation Status

May 12, 2017

Unsure of your participation status in the Merit-based Incentive Payment System (MIPS)? Clinicians can now use an interactive tool on the CMS Quality Payment Program website to determine if they should participate in 2017. To det

ermine your status, enter your national provider identifier (NPI) into the entry field on the tool which can be found on the Quality Payment Program website. Information will then be provided on whether or not you should participate in MIPS this year and where to find resources.

Participation Criteria

You will participate in MIPS in 2017 if you:

  • Bill Medicare Part B more than $30,000 a year AND
  • See more than 100 Medicare patients a year.

You must also be a: 

  • Physician
  • Physician assistant
  • Nurse practitioner
  • Clinical nurse specialist
  • Certified nurse practitioner

If you are new to Medicare in 2017, you do not participate in MIPS. You may also be exempt if you qualify for one of the special rules for certain types of clinicians, or are participating in an Advanced Alternative Payment Model (APM). To learn more, review the MIPS Participation Fact Sheet.

If you are not in the program in 2017, you can participate voluntarily and you will not be subject to payment adjustments.

Participation Notification Letters

The Centers for Medicare & Medicaid Services (CMS) recently sent letters in the mail notifying clinicians of their MIPS participation status. See a sample of the letter (zip) on the education page of https://qpp.cms.gov/. This tool is another resource for clinicians to use to determine their status.

For More Information please visit the Society’s MACRA webpage.

You can also visit the official Quality Payment Program website. The Quality Payment Program Service Center may be reached at 1-866-288-8292 (TTY 1-877-715- 6222), available Monday through Friday, 8:00 AM-8:00 PM ET or via email at QPP@cms.hhs.gov.