This content is excerpted from EyeNet’s MIPS 2023: A Primer and Reference; also see the Academy’s MIPS hub page.
CMS tries to establish 2023 quality measure benchmarks based on 2021 performance data. However, if there wasn’t enough performance data from 2021 to establish a reliable benchmark for a measure, if the measure changed significantly since 2021, or if the measure didn’t exist in 2021, CMS will try to establish a benchmark retroactively using 2023 performance data. But CMS won’t assign a benchmark to a measure unless at least 20 clinicians or groups submit performance data that meet the two data submission thresholds. If CMS is unable to establish a benchmark for a measure, scoring depends on whether it is a new measure in its first or second year or if it is a more established measure.
For new measures in their first or second year of MIPS, a 7- or 5-point floor, respectively. Provided that you meet the data submission thresholds, you will earn a minimum of 7 achievement points for a measure in its first year and a minimum of 5 achievement points for a measure in its second year. For example, the 7-point floor would apply to measure 487: Screening for Social Drivers of Health, which was added to MIPS this year.
For more established measures, 3 of 0 points for small and large practices, respectively. If CMS is unable to establish a benchmark for a measure, small practices will get 3 achievement points for reporting that measure and—new this year—large practices will get 0 achievement points for reporting it.
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