This content is excerpted from EyeNet’s MIPS 2023: A Primer and Reference; also see the Academy’s MIPS hub page.
For some PI measures, scoring is based on your performance rate. You can, for example, score up to 10 points for the e-Prescribing measure. If, for instance, your performance rate is 82%, you would score 8 points. (Note: In calculating this point score, CMS typically rounds off to the nearest whole number. The exception is when the nearest whole number is 0 points; provided you have reported on at least one patient, CMS will round up to 1 point.)
Your performance rate is based on a numerator and a denominator. For the e-Prescribing measure, to continue the example, the denominator is the number of prescriptions written during the performance period for drugs that require prescriptions; and the numerator is the number of those prescriptions that were 1) generated, 2) queried for a drug formulary, and 3) transmitted electronically using a certified EHR. You need a numerator of at least 1 to successfully report the measure.
For information on the numerators and denominators of the performance rate–based measures, see the detailed measure descriptions. Also see the MIPS Tip for boosting your score on the Provide Patients Electronic Access to Their Health Information measure.
Scoring is not performance rate–based for some measures. Scoring is not performance rate–based for:
Exclusions are available for some—but not all—PI measures. If you successfully apply for an exclusion to a PI measure, the PI points that were available for that measure will be reassigned to one or more other PI measures.
All or nothing: Fall short with a required measure and your PI score will be 0%. In order to score more than 0% for the PI performance category, you must either 1) report or 2), if an exclusion is available, claim an exclusion for all the required measures. If you fail to do that, your PI score will be 0% and will contribute 0 points to your MIPS final score. (Note: When you report a numerator, it must be at least 1.)
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