• MIPS 2019—Fundamentals: Bonuses and Penalties

    This content was excerpted from EyeNet’s MIPS 2019; also see the Academy’s MIPS hub page


    Table 4: Bonuses and Penalties

    Your 2019 MIPS final score (0-100 points) will impact your 2021 payments., as shown below.
    2019 MIPS Final Score 2021 Payment Adjustment
    0-7.5 points -7% penalty (negative payment adjustment)
    7.51-29.99 points Penalty of up to -5.25%* (negative payment adjustment)
    30 points Neutral
    30.01-74.99 points Initial bonus (payment adjustment)†
    75-100 points Initial bonus (payment adjustment)† + Exceptional performance bonus (additional payment adjustment)‡

    * The penalty for scoring 7.51-29.99 points is based on a linear sliding scale, as shown in Table 16: Payment Penalty.

    † The initial bonus is based on a linear sliding scale—those who score 30.01 points get the lowest bonus; those who score 100 points get the highest.

    ‡ The exceptional performance bonus is based on a linear sliding scale—those who score 75 points get the lowest bonus; those who score 100 points get the highest.

    CMS has raised the bar. To avoid a payment penalty in 2021, you need a 2019 MIPS final score of at least 30 points (up from 15 points in 2018); to earn an exceptional performance bonus, you need to score at least 75 points (up from 70 points in 2018).

    Potential penalties are higher. The maximum payment penalty has increased to –7% (up from –5% for the 2018 performance year/2020 payment year). 

    Why is there a gap year between performance (2019) and payment adjustments (2021)? CMS needs time to process the MIPS data, determine final scores, calculate an adjustment factor that ensures budget neutrality, and perform a targeted review.

    For a deeper dive, learn how CMS calculates your MIPS Final score, how it determines your payment adjustment, and how the payment adjustment will be applied.

    Previous: Fundamentals: Which Reporting Mechanism?

    Next: Fundamentals: Performance Period

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