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MIPS & Advanced Payment Models

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Ophthalmologists and technicians examine patient records

Under the Merit-based Incentive Payment System (MIPS), ophthalmologists and other eligible clinicians are scored annually across four categories — Quality, Cost, Promoting Interoperability, and Improvement Activities — and their Medicare payment rate is adjusted based on that score. For most ophthalmologists, MIPS participation is not optional: failing to report, or reporting poorly, results in real payment penalties. 

The Academy works on two fronts. On the advocacy side, we work with CMS to keep MIPS practical and sustainable for ophthalmologists by reducing administrative burden and advocating for policies that reflect the realities of ophthalmic practice. On the education and tools side, we provide members with the resources they need to report  successfully and avoid penalties — including the IRIS Registry, the annual Prep Kit, and ongoing coding and compliance guidance. 

Components

Advanced Alternative Payment Models
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Most ophthalmologists have no Advanced Alternative Payment Models (APMs) available to them, and the Academy is working to ensure future payment models are appropriate for ophthalmology practices and their patients.

IRIS Registry Prep Kit
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Everything your practice needs to prepare for successful MIPS reporting through the IRIS Registry — updated each year.

MIPS Value Pathways
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Merit-based incentive payment system (MIPS) value pathways (MVPs) are a new optional MIPS reporting option for ophthalmologists — and Centers for Medicare & Medicaid Services (CMS) has signaled it may eventually become mandatory. 

Quality Measures
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The Academy develops ophthalmology-specific quality measures and advocates for meaningful, specialty-relevant reporting options in the Merit-based Incentive Payment System (MIPS). 

Traditional Merit-Based Incentive Payment System (MIPS)
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MIPS ties payment adjustments to performance across four categories for eligible clinicians. The Academy is here to help ophthalmologists succeed in the program and avoid penalties.

Don't Leave MIPS Points on the Table

Latest News

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Ophthalmologist Jeffrey Carlisle, MD, and team

CMS Proposes Significant MIPS Changes in 2027 Fee Schedule

The Centers for Medicare and Medicaid Services’ (CMS) proposed 2027 rule would sunset Traditional MIPS, mandate MVP reporting, and add a core measure requirement. Here's what you need to know.

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The Academy’s IRIS Registry Continues to Help Ophthalmologists Succeed in MIPS

While cost category concerns remain, The Academy's clinical data registry again helped our members achieve strong performance in the Merit-Based Incentive Payment System (MIPS).

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Academy Fights Policies Limiting How You Treat Patients

The Academy partnered with ASOPRS and NANOS to submit formal written comments to five Medicare administrative contractors on proposed coverage policies for botulinum toxin injections that could override your clinical judgment on treatment decisions.

Our Advocacy in Action

The Academy advocates to keep MIPS workable for ophthalmologists — and provides the tools and registry infrastructure members need to succeed in the program each year.

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75 Points
The Academy advocated to maintain the 75-point MIPS performance threshold through 2028, providing stability for ophthalmology practices.
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Voluntary
The Academy is actively opposing a mandatory transition to MVPs, ensuring ophthalmologists retain the flexibility to choose the reporting option that best meets the needs of their practice and patients.
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IRIS Registry
The Academy's IRIS Registry is a CMS-approved QCDR, giving members access to specialty-specific measures that are more relevant to their practice and their patients.

Join Us in Protecting the Future of Eye Care

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Ophthalmologists advocating on Capitol Hill in Washington, D.C.

OPHTHPAC

The Academy’s political action committee, OPHTHPAC, advocates at the federal level for our members and the patients they treat on critical issues affecting ophthalmology.
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Surgical Scope Fund

Help derail dangerous scope of practice expansion initiatives at the state level that put patient safety at risk by supporting the Surgical Scope Fund.