On Aug. 10, the Centers for Medicare & Medicaid Services released the Merit-based Incentive Payment System (MIPS) performance feedback and final scores for the 2022 performance year, along with 2024 payment adjustment information.
This information determines whether a physician will receive a positive, neutral, or negative payment adjustment on Medicare services furnished in 2024. The 2022 MIPS final score will determine the 2024 payment adjustment information. Adjustments are made on a claim-by-claim basis to payments made for covered professional services furnished by a MIPS-eligible clinician. The payment adjustment is applied to the Medicare paid amount — not the allowed amount. Payment adjustments do not impact the portion of the payment that a patient is responsible for paying. A covered professional service is one in which payment is made based on the Medicare Physician Fee Schedule.
Because MIPS is required to be a budget-neutral program, any projected negative adjustments must be balanced by projected positive adjustments using a scaling factor. The scaling factor is a number between 0 and 3, but the exact amount depends on the distribution of final scores across all MIPS-eligible clinicians in the performance year. For example, if more clinicians receive a final score above the performance threshold, they will see a smaller payment adjustment amount. A scaling factor is also applied to additional adjustments for exceptional performance (a final score of 89 points or greater). The 2022 performance year/2024 payment year is the last year for the additional MIPS payment adjustment for exceptional performance.
MIPS-eligible clinicians can access their performance feedback on the Quality Payment Program (QPP) website. An Items and Services section of the performance feedback provides clinicians with information provided to their patients throughout the calendar year. All items and services are defined by the Healthcare Common Procedure Coding System.
A frequently asked questions document covers the user experience to access the 2022 MIPS Performance Feedback and 2024 Payment Adjustment Information. An adjustment user guide covers how to determine 2024 payment adjustments from a clinician’s 2022 final score. More information can be found in the QPP Resource Library.
Sources:
https://documents.cap.org/documents/2022MIPSFeedbackFAQs.pdf?_gl=1*hbtku1*_ga*OTI5NjU5NTIyLjE2NzcwODA0MDA.*_ga_97ZFJSQQ0X*MTY5MzkxOTY2NC45LjEuMTY5MzkyMDIyOC4wLjAuMA..
https://www.cap.org/advocacy/latest-news-and-practice-data/august-29-2023#story2
https://documents.cap.org/documents/2024MIPSPaymentAdjustmentGuide.pdf?_gl=1*hbtku1*_ga*OTI5NjU5NTIyLjE2NzcwODA0MDA.*_ga_97ZFJSQQ0X*MTY5MzkxOTY2NC45LjEuMTY5MzkyMDIyOC4wLjAuMA..
