On Nov. 2, the Centers for Medicare & Medicaid Services (CMS) published the CY 2022 Medicare Physician Fee Schedule (PFS) Final Rule, which includes the final policies for the 2022 performance year of the Quality Payment Program (QPP).
The changes to performance category weighting and performance thresholds are in line with MACRA legislation requirements for the 2022 performance year. Included in the final rule are details for MIPS Value Pathway (MVP) scoring and the first list of approved MVPs for the 2023 performance year, including a rheumatology MVP submitted by the ACR. Notably, the CMS is also thinking of sunsetting traditional MIPS by the end of the 2027 MIPS performance year/2029 MIPS payment year in favor of MVP and Alternative Payment Model (APM) participation. Lastly, a major takeaway is that avoiding a penalty in MIPS will become harder, because the performance threshold will be increased to 75 points and quality bonus points will be removed.
The ACR RISE registry staff reviewed the final rule and highlight below critical policy changes for the 2022 MIPS reporting period. You are also encouraged to check out the ACR Overview of 2022 Medicare Physician Fee Schedule Final Rule. If you have questions or concerns about how these proposed changes may affect your practice, contact RISE staff at [email protected].
Performance Category Weights
- Quality: 30% for PY 2022 (40% for PY 2021)
- Cost: 30% for PY 2022 (20% for PY 2021)
- Promoting Interoperability: 25% for PY 2022 (no change from PY 2021)
- Improvement Activities: 15% for PY 2022 (no change from PY 2021)
- Performance threshold: 75 points (60 points for CY 2021)
- Additional performance threshold for exceptional performance: 89 points (85 points for CY 2021)
The CMS notes that the 2022 performance year/2024 payment year is the final year for an additional performance threshold/additional MIPS adjustment for exceptional performance.
Quality Performance Category
Beginning with the 2022 performance period, there are no bonus points for reporting additional outcome and high priority measures beyond the one required. In addition, there are no bonus points for measures that meet end-to-end electronic reporting criteria.
The CMS will also remove the three-point floor for scoring measures, with some exceptions for small practices, beginning with the 2023 performance period. Lastly, the CMS updated the quality measure inventory, and there are a total of 200 quality measures available for the 2022 performance period.
Quality Performance Category Collection Types