Beginning in 2019, physicians participating in the MIPS will be eligible for positive, negative or neutral Medicare payment adjustments that start at 4 percent and gradually increase to 9 percent for 2022. The threshold for these payment adjustments will be the mean composite score for all MIPS-eligible professionals during the previous performance period.
Participation in an APM can help with composite score for a MIPS professional
Physicians whose composite score is at the threshold (i.e., earn the mean composite score) will not receive a MIPS payment adjustment.
Physicians whose composite scores are above the threshold will receive positive payment adjustments on each claim for the following year.
Physicians whose composite scores are below the threshold will receive negative payment adjustments on each claim for the following year.
Physicians with high composite scores will be eligible for a positive payment adjustment that is up to three times the baseline positive payment adjustment for a given year. For example, the baseline positive payment adjustment for 2019 will be 4 percent, so high performers will be eligible for a positive payment adjustment of up to 12 percent.
Beginning in 2026, all physicians participating in the MIPS will be eligible for a 0.25 percent increase in their payments each year.