The Rheumatologist
COVID-19 News
  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed
  • Home
  • Conditions
    • Rheumatoid Arthritis
    • SLE (Lupus)
    • Crystal Arthritis
      • Gout Resource Center
    • Spondyloarthritis
    • Osteoarthritis
    • Soft Tissue Pain
    • Scleroderma
    • Vasculitis
    • Systemic Inflammatory Syndromes
    • Guidelines
  • Resource Centers
    • Ankylosing Spondylitis Resource Center
    • Gout Resource Center
    • Rheumatoid Arthritis Resource Center
    • Systemic Lupus Erythematosus Resource Center
  • Drug Updates
    • Biologics & Biosimilars
    • DMARDs & Immunosuppressives
    • Topical Drugs
    • Analgesics
    • Safety
    • Pharma Co. News
  • Professional Topics
    • Ethics
    • Legal
    • Legislation & Advocacy
    • Career Development
      • Certification
      • Education & Training
    • Awards
    • Profiles
    • President’s Perspective
    • Rheuminations
  • Practice Management
    • Billing/Coding
    • Quality Assurance/Improvement
    • Workforce
    • Facility
    • Patient Perspective
    • Electronic Health Records
    • Apps
    • Information Technology
    • From the College
    • Multimedia
      • Audio
      • Video
  • Resources
    • Issue Archives
    • ACR Convergence
      • Systemic Lupus Erythematosus Resource Center
      • Rheumatoid Arthritis Resource Center
      • Gout Resource Center
      • Abstracts
      • Meeting Reports
      • ACR Convergence Home
    • American College of Rheumatology
    • ACR ExamRheum
    • Research Reviews
    • ACR Journals
      • Arthritis & Rheumatology
      • Arthritis Care & Research
      • ACR Open Rheumatology
    • Rheumatology Image Library
    • Treatment Guidelines
    • Rheumatology Research Foundation
    • Events
  • About Us
    • Mission/Vision
    • Meet the Authors
    • Meet the Editors
    • Contribute to The Rheumatologist
    • Subscription
    • Contact
  • Advertise
  • Search
You are here: Home / Articles / 2021 Merit-Based Incentive Payment System Payment Adjustments, Explained

2021 Merit-Based Incentive Payment System Payment Adjustments, Explained

September 4, 2020 • By Allison Plitman

  • Tweet
  • Email
Print-Friendly Version / Save PDF

When the 2019 Merit-Based Incentive Payment System (MIPS) final scores were released, many clinicians raised questions related to their 2021 payment adjustments. Compared with previous years, more clinicians received neutral payments for scores that would have netted positive payments in the first two years of the Quality Payment Program.

You Might Also Like
  • CMS 2020 Quality Payment Program Proposed Rule Contains Key Changes to MIPS Reporting
  • 2019 MIPS Deadline Extension & Policy Update
  • CMS Releases 2021 Proposed Rule for the Quality Payment Program
Also By This Author
  • Hundreds of Providers Use RISE for 2019 QPP Reporting

The Centers for Medicare & Medicaid Services (CMS) applies adjustments to Medicare reimbursements for certain services based on individual participation and performance in MIPS. Each MIPS-eligible clinician’s final score forms the basis of their payment. The funding created by negative payment adjustments forms the pool used for positive payment adjustments.

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

Due to the SARS-CoV-2 pandemic, many eligible clinicians did not submit data for 2019 MIPS. Under the automatic extreme and uncontrollable circumstances policy for 2019 MIPS, CMS assigned these clinicians a neutral payment adjustment instead of the maximum negative payment adjustment. With almost no negative adjustments for 2019 MIPS, the available funding cannot support positive payment adjustments in 2021.

This year, MIPS-eligible clinicians with a final score between 30.01–74.99 points earned a neutral 2021 payment adjustment of 0.00%. MIPS-eligible clinicians with a final score above the performance threshold (75.00 points for the 2019 performance year) are eligible for an additional positive adjustment for exceptional performance. The funds for exceptional performance are not dependent on negative payment adjustments, so clinicians meeting the 75-point threshold will receive a positive payment adjustment.

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

Although clinicians have to account for these changes in MIPS payment adjustments, the proposed Physician Fee Schedule does include some financial wins for rheumatology professionals, including an expected average 16% payment increase for rheumatologists.

Clinicians who believe an error was made in their scoring and payment can submit a targeted review to CMS until 8 p.m. EDT on Oct. 5, 2020.

To learn more, read the 2021 MIPS Payment Year Payment Adjustment Fact Sheet or contact the CMS QPP Service Center at QPP@cms.hhs.gov.

ad goes here:advert-3
ADVERTISEMENT
SCROLL TO CONTINUE

Allison Plitman, MPA, is the communications specialist for the ACR’s RISE Registry.

Filed Under: Quality Assurance/Improvement Tagged With: Merit-Based Incentive Payment System (MIPS), Quality Payment Program, Rheumatology Informatics System for Effectiveness (RISE) Registry

You Might Also Like:
  • CMS 2020 Quality Payment Program Proposed Rule Contains Key Changes to MIPS Reporting
  • 2019 MIPS Deadline Extension & Policy Update
  • CMS Releases 2021 Proposed Rule for the Quality Payment Program
  • Quality Payment Program Year 3 Reporting Changes: What You Need to Know

Simple Tasks

Learn more about the ACR’s public awareness campaign and how you can get involved. Help increase visibility of rheumatic diseases and decrease the number of people left untreated.

Visit the Simple Tasks site »

American College of Rheumatology

Visit the official website for the American College of Rheumatology.

Visit the ACR »

Meeting Abstracts

Browse and search abstracts from the ACR Convergence and ACR/ARP Annual Meetings going back to 2012.

Visit the Abstracts site »

The Rheumatologist newsmagazine reports on issues and trends in the management and treatment of rheumatic diseases. The Rheumatologist reaches 11,500 rheumatologists, internists, orthopedic surgeons, nurse practitioners, physician assistants, nurses, and other healthcare professionals who practice, research, or teach in the field of rheumatology.

About Us / Contact Us / Advertise / Privacy Policy / Terms of Use

  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed

Copyright © 2006–2021 American College of Rheumatology. All rights reserved.

ISSN 1931-3268 (print)
ISSN 1931-3209 (online)

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.