This content is excerpted from EyeNet’s MIPS 2023: A Primer and Reference; also see the Academy’s MIPS hub page.
Some low-volume clinicians will be able to opt in. If you fall below one or two—but not all three—of the low-volume exclusion thresholds, you have a choice of being exempt from MIPS or electing to opt in to the program. (This option isn’t available if you fall below all three thresholds.)
How do you know if you are eligible for opt-in status? Use the QPP Participation Status Lookup Tool (see “What’s Your MIPS Participation Status?”).
How do you opt in to MIPS? Assuming that CMS offers the same opt-in procedures as it has used in previous years, you will be able to opt in for performance year 2022 by signing into your account at qpp.cms.gov; the window for opting in would open in January 2024, when CMS opens the submission window for performance year 2023.
What are the consequences of opting in? If you opt in for the 2023 performance year, your 2025 payments will be subject to a MIPS payment adjustment based on your 2023 MIPS final score. You also will be eligible to have your data published on Care Compare, a website that CMS has set up to enable the public to see performance data on physicians who participate in Medicare. Once you have elected to opt in to MIPS for 2023, that decision is binding for that performance year.
An alternate option: Voluntary reporting. If you are excluded from MIPS, you can choose to voluntarily report. You will receive feedback reports, but—unlike those who choose to opt in—your 2025 payments won’t be subject to a MIPS payment adjustment, and any quality data that you report won’t be included when CMS calculates measure benchmarks.
Note: If you voluntarily report, your performance information may appear on Care Compare; however, during the preview period at the start of 2025, voluntary reporters can ask that their information not be publicly reported.
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