Quality Payment Program: Determine MIPS Eligibility With This 2020 Primer

Why This Topic Matters

MIPS eligibility affects whether a clinician or practice must participate in the program and how performance information is handled for the year. Understanding the eligibility framework helps providers assess status, monitor updates, and avoid missing participation or exemption determinations.

Article Sections

1. Understand the Nuances of Clinician Types

   Summarizes the clinician categories discussed in QPP guidance and explains that specialty type is part of the eligibility screen. It also notes that eligibility is tied to provider and organization identifiers.

2. See Low-Volume Threshold Details

   Reviews the low-volume threshold framework used in the eligibility decision process and describes the general types of Medicare Part B activity considered. It also introduces the main participation pathways discussed in the article.

3. Know These MIPS Determination Dates and Facts

   Explains the general timing and review structure CMS uses when making eligibility determinations during the performance year. It also covers how preliminary and final eligibility information is reconciled and released.