American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

MIPS Scoring and Payment Adjustments

MIPS 2019 Performance Year

Final Score

An eligible clinician’s (EC's) performance in each of the four Merit-based Incentive Payment System (MIPS) components makes up the EC’s MIPS final score, determining the EC’s payment adjustment. Payment adjustments can be positive, negative, or neutral. A single MIPS final score will factor in performance in the four categories on a 0 to 100 point scale. Each MIPS component is weighted differently in calculating the MIPS final score.

MIPS Component

Scoring Weight (for 2019 performance year)

Quality

45 percent

Promoting Interoperability (formerly ACI)

25 percent

Improvement Activities

15 percent

Cost

15 percent

Payment Adjustments

Payment adjustments are applied based on an EC’s performance two year prior to the calendar year. Therefore, an EC who is a MIPS participant in 2019 will receive a payment adjustment in 2021 based on 2019 data. For 2019 MIPS participants, a maximum of a 7 percent is possible in calendar year 2021. 

Calendar Year

Maximum Possible +/- Payment Adjustment

2019

4 percent (based on 2017 performance)

2020

5 percent (based on 2018 performance)

2021

7 percent (based on 2019 performance)

2022 and onward

9 percent (based on 2020 performance)

MIPS 2018 Performance Year

Final Score

An EC’s performance in each of the four MIPS components makes up the EC’s MIPS final score, determining the EC’s payment adjustment. Payment adjustments can be positive, negative, or neutral. A single MIPS final score will factor in performance in the four categories on a 0 to 100 point scale. Each MIPS component is weighted differently in calculating the MIPS final score.

MIPS Component

Scoring Weight (for 2018 performance year)

Quality

50 percent

Promoting Interoperability (formerly ACI)

25 percent

Improvement Activities

15 percent

Cost

10 percent

Payment Adjustments

Payment adjustments are applied based on an EC’s performance two years prior to the calendar year. Therefore, an EC who is a MIPS participant in 2018 will receive a payment adjustment in 2020 based on 2018 data. For 2018 MIPS participants, a maximum of a 5 percent payment adjustment is possible in calendar year 2020.

Calendar Year

Maximum Possible +/- Payment Adjustment

2019

4 percent (based on 2017 performance)

2020

5 percent (based on 2018 performance)

2021

7 percent (based on 2019 performance)

2022 and onward

9 percent (based on 2020 performance)