This content is excerpted from EyeNet’s MIPS 2021; also see the Academy’s MIPS hub page.
This can be described as a five-step process.
1. Achievement points: CMS determines your total measure achievement points, which is the sum of your achievement points for up to six quality measures that you reported plus—if applicable—your score for the HWR measure (see “The HWR Measure for Large Practices”).
2. Measure bonus points: CMS determines your total measure bonus points (see “Scoring—Bonuses for High- Priority Measures and CEHRT”).
3. Numerator: CMS calculates your numerator, which is your total measure achievement points plus your total measure bonus points plus—if you are in a small practice that submits data on at least one quality measure—a 6-point small practice bonus.
4. Denominator: CMS calculates your denominator, also known as your total available measure achievement points, which—assuming that you had at least six quality measures available to report—is 60 (or 70 if the HWR measure applies). In limited circumstances, CMS may determine that you have fewer than six quality measures to report and can reduce that denominator accordingly.
5. CMS does the math: CMS divides your numerator by your denominator, turns the resulting fraction into a percentage, and then your improvement percent score is added.
The resulting percentage is your quality performance category percent score, which is capped at 100%. Unless your performance categories are reweighted (see “Table 1: How the Performance Categories Are Weighted”), it contributes up to 40 points to your MIPS final score. For example, if your quality score is 60%, it would contribute 24 points (60% of 40 points).
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