MIPS Performance Categories
There are four performance categories that make up a provider’s final score. This final score determines the payment adjustment. For audiologists, reporting will be limited to the Quality, Clinical Improvement, and Promoting Interoperability categories.
Eligibility Standards and Conditions
As a result of program exclusions and low-volume thresholds, a large majority of audiologists are not currently required to participate under MIPS. Clinicians must meet ALL of the following criteria in order to be required to participate:
- bill $90,000 or more to the Medicare program
- treat 200 or more distinct Medicare beneficiaries
- provide 200 or more distinct procedures
Clinicians meeting one or two of the criteria may opt into the program to compete for payment adjustments. Others who do not meet any of the criteria may voluntarily report in order to gain experience. Required participants who choose not to report or who do not report successfully, will be subject to the maximum payment reduction of -9 percent.