5 Facts Your Eyecare Practice Should Know about MIPS


MIPS. We know by now you've heard of it, but do you really know what it's all about and how it can affect your eyecare practice? Just when you think you understand the latest regulations and rules, something new comes out and there is a whole new set of requirements you need to get up to speed with. Today we want to share five fast facts about the MIPS program to help you better understand who needs to participate, the adjustment effects, how it's scored, and the timeline to be aware of to get started. 

5 Fast Facts to Prepare Your Eyecare Practice for MIPS

EligibilityMIPS for eyecare practices

ODs must comply with the program if they fall under these rules:

  • Medicare part B clinician billing more than $30k a year AND
  • Provides care to more than 100 Medicare patients a year

The Adjustment Period

January 1, 2017 marks the beginning of the measuring period for MIPS, but payment adjustments won't start to take effect until 2019. Here's what the adjustments look like starting in 2019:

  • +/- 4% in 2019
  • +/- 5% in 2020
  • +/- 7% in 2021
  • +/- 9% in 2022

MIPS Categories

MIPS participation is weighted in 4 different categories. If you've participated in Meaningful Use, some of this will be familiar. The 4 categories include:

  • Quality (essentially replaces PQRS)
  • Avanced Care Info (similar to Meaningful Use)
  • Resource Use/Cost (no action required at this point)
  • Clinical Practice Improvement Activities (CPIA - new)


Scoring within each of the 4 categories listed about works a little differently for each. Here's a quick summary:

  • Quality: Each measure submitted is scored 1-10 points based on performance. Bonus points are available.
  • Advanced Care Info: 3 different point-based scoring categories - base score, performance score, and bonus score.
  • Resource Use/Cost: Derived from calculations based on expenditures through claims data.
  • Clinical Practice Improvement Activities: Each activity is weighted either 10 or 20 points, and depending on practice size, ODS must score between 20 or more points.


Important dates to know for your MIPS timeline:

  • January 1, 2017: Can start tracking your performance
  • October 2, 2017: Last day to meet the 90-day partial reporting option for 2017
  • December 31, 2017: End of performance reporting options for 2017
  • March 31, 2018: All performance data for 2017 must be reported
  • January 1, 2019: First payment adjustments based on 2017 performance will go into effect

Watch our popular MIPS webinar now.


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