MIPS FAQs

MIPS determines a meaningful share of Medicare Part B reimbursement for most physicians and other eligible clinicians, yet the program’s mechanics are rarely intuitive on first read. Eligibility depends on billing thresholds assessed across two separate measurement windows. A single composite score, built from four categories carrying different weights, decides whether a practice’s future payments rise, hold steady, or fall. And because CMS revises measures, weights, and requirements through annual rulemaking, a rule that held last year may not hold this one. The result is a program that rewards careful attention to detail and penalizes assumptions carried over from a prior reporting year. 

The FAQ pages below address that complexity directly, organized around the questions practices most commonly need answered: the statutory basis for MIPS and current eligibility criteria, how the four performance categories are weighted and scored, the available paths for submitting data, the Security Risk Analysis and related attestations required to earn any Promoting Interoperability credit, the exceptions and automatic accommodations that can change a practice’s obligations entirely, and the specific deadlines and data thresholds that govern whether submitted information counts. 

Please schedule a consultation if you are looking for a Security Risk Analysis (SRA) for MIPS or Expert Consultants to help you navigate the process.