Skip to main content
  • MIPS 2019—Bonuses and Penalties: How the Payment Adjustments Will Be Applied

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


    You can  report and be scored as an individual or as part of a group. If you are scored as an individual, CMS will use both your Tax Identification Number (TIN) and National Provider Identifier (NPI) to distinguish you as a unique MIPS participant. If you and your colleagues report as a group, the group’s TIN will be used as your identifier for scoring purposes. You also can report both ways and see which approach scores higher (see "What if you report as an individual and as part of a group?").

    Payment adjustments are always applied at the TIN/NPI level. CMS will apply the payment adjustments at the TIN/NPI level, regardless of whether you were assigned a MIPS final score as an individual or as part of a MIPS group.

    Your 2019 final score will follow you to your next practice. Your 2019 final score will determine your 2021 payment adjustment, and this is the case even if you move to a new practice after the 2019 performance year is over. 

    How the payment adjustments will be applied. CMS will start applying the MIPS payment adjustments in 2021. They will be applied throughout the year to each claim that you submit.

    Previous: Bonuses and Penalties: How CMS Calculates Your Payment Adjustment

    Next: Your 9-Step To-Do List for MIPS Resources

    DISCLAIMER AND LIMITATION OF LIABILITY: Meeting regulatory requirements is a complicated process involving continually changing rules and the application of judgment to factual situations. The Academy does not guarantee or warrant that regulators and public or private payers will agree with the Academy’s information or recommendations. The Academy shall not be liable to you or any other party to any extent whatsoever for errors in, or omissions from, any such information provided by the Academy, its employees, agents, or representatives.

    COPYRIGHT© 2019, American Academy of Ophthalmology, Inc.® All rights reserved. No part of this publication may be reproduced without written permission from the publisher. American Academy of Ophthalmic Executives® and IRIS® Registry, among other marks, are trademarks of the American Academy of Ophthalmology®.

    All of the American Academy of Ophthalmology (AAO)–developed quality measures are copyrighted by the AAO’s H. Dunbar Hoskins Jr., MD, Center for Quality Eye Care (see terms of use).