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2018 MIPS: Are you in or out?

04/25/2018 4:36 PM | Rebekah Francis (Administrator)

To determine 2018 MIPS eligibility, physician practice leaders must check the participation status for each clinician by inputting his or her national provider identified (NPI) in the MIPS look-up tool. Previously, CMS mailed letters to practices to inform them of their eligibility status, but the agency does not plan to notify medical groups about their eligibility in 2018. Practices should not rely on historic eligibility determinations, as many physicians and medical groups who were required to participate in MIPS in 2017 will be exempt in 2018 under the expanded low-volume threshold. 

MGMA is engaged in discussions with CMS officials about the limitations of the look-up tool and asked the agency to enhance the tool’s functionality by making available eligibility data for all NPIs who have reassigned their billing rights to the group practice, rather than requiring eligibility data to be accessed on an NPI-by-NPI basis.


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