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CMS Quality Payment Program → MIPS

MIPS Eligibility and Participation (2019) (MIPS19-103)

This series of courses will walk you through details of the CY 2019 Quality Payment Program final rule under the MACRA (Medicare Access and CHIP Reauthorization Act of 2015) law. This final rule addresses changes to the Medicare physician fee schedule (PFS) and other Medicare Part B payment policies, as well as policies included in the interim final rule with comment period in “Medicare Program; CY 2018 Updates to the Quality Payment Program; and Quality Payment Program: Extreme and Uncontrollable Circumstance Policy for the Transition Year.” This final rule also addresses a subset of the changes to the Medicare Shared Savings Program for Accountable Care Organizations (ACOs) proposed in the August 2018 proposed rule “Medicare Program; Medicare Shared Savings Program; Accountable Care Organizations—Pathways to Success”, as well as certain other revisions designed to update program policies under the Shared Savings Program.

The regulations outlined on the following pages are effective on January 1, 2019, except for the following:
1. Revisions to §§ 414.1415(b)(2) and (3), and 414.1420(b), (c)(2), and (3), which are effective January 1, 2020; and
2. Amendments to Part 425, which are effective on December 31, 2018.
  • Learning Objectives
  • Eligibility Pre-Test
  • I. Overview
  • II. MIPS Determination Periods
  • III. Low-Volume Threshold
  • IV. Partial QPs, Group Reporting, and Virtual Groups
  • V. MIPS Performance Period
  • Eligibility Post-Test
  • Feedback Survey
  • Thank you!
Completion rules
  • All units must be completed