PTs, OTs and SLPs who participate in MIPS in 2020 (the “performance year”) will be subject to a payment adjustment to their Medicare Part B reimbursement in 2022 (the “payment year”). This payment adjustment can be positive, negative or neutral based on the individual clinician’s or group’s performance in the program.
For the 2022 payment year, the MIPS Performance Threshold is 45 points (out of 100). Individual clinicians and groups who achieve 45 total points will receive a neutral payment adjustment, below 45 receive a negative adjustment (penalty) and above 45, a positive one (incentive). Payment adjustments in 2022 can be as much as + or – 9%. (NOTE: Payment adjustments are “budget neutral,” meaning the incentive pool is equal to the penalty pool. Incentives are earned by eligible clinicians/groups based on performance relative to those who receive penalties for substandard performance.)
The eligible clinician’s or group’s performance in the Quality and Improvement Activities categories will be weighted and added together to determine the total performance score out of 100. Having a general understanding of scoring in both categories will help clinicians make informed decisions about MIPS participation, measure selection and process implementation.
For more information, read Casamba’s MIPS Scoring for PT/OT/ST in 2020.