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.

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. 

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.

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.