February 27th, 2017
Question: Is it true that I can opt out of MIPS & MACRA if my part B charges are less than or equal to $30,000? If so, are the charges based on covered Medicare charges (98940, 98941, 98942) or all charges sent to Medicare? Some patients want non-covered charges sent to Medicare too.
Answer: In order to be eligible for MIPS incentives or penalties, you need $30,000 in covered services only AND you also need to see 100 unique beneficiaries. However, voluntary participation may be wise just to get used to the program and earn a Composite Score for assessment on CMS's Physician Compare web site. The administrative burden may not be too high if you already participated in PQRS and Meaningful Use in the past.