• MIPS Eligibility Criteria—What’s New for 2019

    Written By: Chris McDonagh and Jessica Peterson, MD, MPH

    Excerpted from “MIPS—What’s New for 2019”, a two-part EyeNet series (January and February, 2019), published online ahead of print. You also should bookmark EyeNet's MIPS 2019 (also published online ahead of print) and the Academy's MIPS hub page.


    More clinicians are eligible to participate. CMS expanded the definition of MIPS eligible clinician to include six additional types of clinician:

    • physical therapists
    • occupational therapists
    • qualified speech-language pathologists
    • qualified audologists
    • clinical psychologists
    • registered dieticians and nutrition professionals

    None of these are likely to be found in an ophthalmology practice.

    Low-volume clinicians now have an opt-in option. In 2018, you were excluded from MIPS if you fell below either of two low-volume thresholds. For 2019, CMS added an opt-in option: You can choose to participate in MIPS if you fall below at least one, but not all, of the low-volume thresholds, which now include a third threshold: Providing 200 or more covered professional services to Medicare Part B patients.

    At time of press, CMS had not yet set a deadline for opting in. If you do opt in for 2019, you will be subject to a payment adjustment in 2021. And you can’t change your mind—the decision is irrevocable until the next performance year.

    Previous: MIPS Final Score, Penalties, Bonuses—What’s New for 2019

    Next: MIPS Determination Periods—What’s New for 2019

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