Lookup Tool to Determine MIPS Eligibility Now Available

May 10th, 2017

Is your practice and/or provider unsure of their participation status in the Merit-based Incentive Payment System (MIPS)? No need to worry, because Medicare has released a tool on their website to determine if you should participate in 2017.

To determine your status, enter your national provider identifier (NPI) into the entry field on the tool which can be found on the Quality Payment Program website at https://qpp.cms.gov/learn/eligibility. Information will then be provided on whether or not you should participate in MIPS for each Tax ID number you are associated with.

Participation Criteria

You will participate in MIPS in 2017 if you:

  • Bill Medicare Part B more than $30,000 a year AND See more than 100 Medicare patients a year.

You must also be a:

  • Physician
  • Physician assistant
  • Nurse practitioner
  • Clinical nurse specialist
  • Certified nurse practitioner

If you are new to Medicare in 2017, you do not participate in MIPS. You may also be exempt if you qualify for one of the special rules for certain types of clinicians, or are participating in an Advanced Alternative Payment Model (APM). To learn more, review the MIPS Participation Fact Sheet.