QPP MIPS Reporting
Discover how Care Gain Solutions optimizes performance across all medical specialties by delivering targeted MIPS reporting strategies and customized quality measures selection.
MIPS Reporting:
The Merit-Based Incentive Payment System (MIPS) is one of the most critical programs developed by the U.S. Centers for Medicare & Medicaid Services (CMS) under the Medicare Access and CHIP Reauthorization Act (MACRA). MIPS reporting has become a significant part of the healthcare industry, encouraging all healthcare providers to deliver high-quality care services at a lower cost to Medicare beneficiaries while earning rewarded benefits.
MIPS reporting evaluates clinicians across 04 components:
Quality
Promoting Interoperability
Improvement Activities
Cost
Who Is Eligible for MIPS Reporting?
- Physicians (MDs & DOs) — including psychiatrists, cardiologists, neurologists, surgeons, oncologists, and other specialties
- Dentists (DDS & DMD)
- Podiatrists (DPMs)
- Optometrists (ODs)
- Chiropractors
- Physician Assistants (PAs)
- Nurse Practitioners (NPs)
- Clinical Nurse Specialists (CNSs)
- Certified Registered Nurse Anesthetists (CRNAs)
- Physical & Occupational Therapists
- Clinical Psychologists
- Speech-Language Pathologists
- Audiologists
- Registered Dietitians & Nutrition Professionals
- Clinical Social Workers
- Certified Nurse-Midwives
Low Volume Threshold
The low-volume threshold is based on three main factors:
- Bill more than $90,000 for Medicare Part B services.
- See more than 200 Medicare Part B patients.
- Provide more than 200 Medicare Part B services.
QPP MIPS Reporting Components
Performance Threshold for PY 2026
The MIPS Performance Threshold is set at 75 points out of 100. Clinicians who score below 75 may receive a negative payment adjustment of up to 9%, while those who score above the threshold will qualify for positive payment adjustments. Accurate and timely MIPS reporting is essential to maintaining a strong performance score and maximizing reimbursement opportunities.
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