This content was excerpted from EyeNet’s MIPS Manual 2017.
Individuals. If you are participating in MIPS as an individual, CMS will use both your Tax Identification Number (TIN) and National Provider Identifier (NPI) to distinguish you as a unique MIPS participant. You must use the same TIN/NPI combination for all performance categories. If you report more than 1 TIN/NPI combination—because, for instance, you practice in more than 1 location or you move to a new practice—you will be assessed separately for each TIN. Physicians in such situations should meet the reporting requirements at all the TIN/NPI combinations where they practice during the performance year.
MIPS groups. If you and your colleagues choose to participate jointly as a group, the group’s TIN alone will be your identifier for all the performance categories.
APM entity group. If you and your colleagues participate jointly as an APM entity group, each MIPS eligible clinician within that group would be identified by a unique APM participant identifier. For example, all clinicians participating in a track 1 ACO will receive the same score.
Bonuses and penalties. Payment adjustments will be applied at the TIN/NPI level, regardless of whether you participate in MIPS as an individual, as part of a MIPS group, or as part of an APM entity group.
Your 2017 final score will follow you to your next practice. Your final score for the 2017 performance year will impact your payment adjustment during the 2019 payment year, and—unlike PQRS—this is the case even if you move to a new practice after the 2017 performance year finishes. In other words, when CMS determines your 2019 payment adjustment, it will look at the 2017 final score that was associated with the TIN you were using in 2017, not the 2017 final score that is associated with your new practice’s TIN.
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