• MIPS 2021— Harder to Avoid the Penalty

    This content is excerpted from EyeNet’s MIPS 2021; also see the Academy’s MIPS hub page.

    Performance threshold is now 60 points. Your 2023 Medi­care Part B payments will be penalized if your 2021 MIPS final score falls below a performance threshold of 60 points (see Table: Performance Penalty). This is up from 45 points last year.

    You may need to update your MIPS strategy. Because of this higher performance threshold, you can’t assume that you will avoid the penalty with the same mea­sures and the same level of performance as last year.

    Quality’s weight reduced; cost’s weight increased. Your MIPS final score is based on your weighted scores in up to four performance categories. The quality performance category and cost perfor­mance category are weighted at 40% and 20%, respectively, of your MIPS final score in 2021, compared with 45% and 15% in 2020.

    Note: In 2021, ophthalmologists who don’t perform cataract surgery are likely to be excluded from the cost performance category, in which case cost’s weight in the MIPS final score would be reallocated to quality in most reweighting scenarios (see Table 1: How the Performance Categories Are Weighted).

    Previous: Your Guide to MIPS Acronyms 

    Next: What’s New With Quality 

    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© 2021, 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).