Merit-based Incentive Payment System (MIPS)

What is the Merit-based Incentive Payment System (MIPS)?

The Merit-based Incentive Payment System (MIPS) is one of the two participation tracks within the Centers for Medicare & Medicaid Services (CMS) Quality Payment Program (QPP). MIPS adjusts Medicare Part B payments based on clinician performance in areas such as quality, cost, improvement activities, and promoting interoperability. For anesthesiologists, MIPS performance can directly affect Medicare reimbursement, making it important to understand eligibility requirements and reporting obligations.

Who Needs to Participate?

Clinicians and groups generally must participate in MIPS if they exceed all three CMS low-volume threshold criteria:

• More than $90,000 in Medicare Part B allowed charges.
• More than 200 Medicare beneficiaries.
• More than 200 covered professional services.

What is ASA Doing?

ASA advocates on behalf of anesthesiologists to shape the Quality Payment Program (QPP), reduce administrative burden, and promote fair, clinically relevant quality measures. Through engagement with the Centers for Medicare & Medicaid Services (CMS) and collaboration with specialty societies, ASA works to improve reporting pathways and payment policies.

ASA's efforts include:

• Submitting comments to CMS on annual QPP and Medicare Physician Fee Schedule rules, addressing reporting requirements, scoring methodologies, and administrative burden.
• Collaborating with specialty societies and coalitions to improve the Merit-based Incentive Payment System (MIPS), MIPS Value Pathways (MVPs), and other value-based payment models.
• Supporting anesthesiology-specific reporting through the Anesthesia Quality Institute (AQI) National Anesthesia Clinical Outcomes Registry (NACOR), helping clinicians meet QPP requirements and benchmark performance.