4 Reasons You Might be Excluded from MIPS

With MIPS looming on the horizon in 2017, many optometrists are anxious about meeting the program requirements. The first step in determining how to meet MIPS requirements is to determine whether you even have to.

Who’s Required?

According to the final rule, CMS anticipates that 24,252 or 66% of optometric clinicians will be excluded from MIPS in 2017.

Clinicians who fall under one of the following categories are excluded from the first year of MIPS:

  • Clinicians who see 100 or fewer Medicare Part B patients;
  • Clinicians who bill $30,000 or less in Medicare Part B;
  • Clinicians in their first year of Medicare Part B billing; or
  • Clinicians who are participating in an Advanced APM (alternative payment model, more on this later).

Each of these criteria excludes Medicare Parts A, C, and D from eligibility requirements.

It’s important to note that these exclusions are expected change in subsequent MIPS program years.

Next Up: When Should I begin MIPS?

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Masoud Nafey, OD

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