• MIPS 2019—Quality: How CMS Calculates Your Quality Score

    This content was excerpted from EyeNet’s MIPS 2019; also see the Academy’s MIPS hub page

    The way that MIPS calculates your quality performance category score can be described as a five-step process.

    1. 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 achievement score for the ACR measure.
    1. CMS determines your total measure bonus points (see Bonuses for High-Priority Measures and CEHRT).
    1. 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—a 6-point small practice bonus.
    1. 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 ACR measure applies). In limited circumstances, CMS may determine that you have fewer than six quality measures to report and can reduce that denominator accordingly.
    1. CMS divides your numerator by your denominator, turns the resulting fraction into a percentage, and then adds your improvement percent score.

    The resulting percentage is your quality performance category percent score, which is capped at 100%. Unless your performance categories are reweighted (see Table 5) it contributes up to 45 points to your final score. For example, if your quality score is 60%, it would contribute 27 points (60% of 45) to your MIPS final score.

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