Toolkits

MACRA Matters Toolkit 

MACRA, MIPS and the Quality Payment Program

The Quality Payment Program, established through the 2015 Medicare Access and CHIP Reauthorization Act (MACRA), is the Centers for Medicare and Medicaid Services' new medicare reimbursement program, replacing the sustainable growth rate (SGR) and a patchwork of programs focused on resources use, health information and quality with this value-based program.

MIPS eligible clinicians who participated in the 2019 performance period of the Quality Payment Program (QPP) can submit data from January 2, 2020, at 10:00 a.m ET until April 30, 2020, at 8:00 p.m. ET. The original deadline was March 31, 2020, 8:00 p.m. ET. Follow these steps:

  • Go to the Quality Payment Program website
  • Sign in using your QPP access credentials
  • Submit your MIPS data for the 2019 performance period or review the data reported on your behalf by a third party

Participants can also check their 2020 MIPS eligibility through CMS’ updated Quality Payment Program Participation Status Lookup Tool. To be eligible, clinicians must exceed all three of the criteria below; however, clinicians meeting some but not all of these criteria may “opt in”:

  • Bill more than $90,000 a year in allowed charges under the Medicare Physician Fee Schedule (MPFS)
  • Provide professional services to more than 200 Medicare Part B beneficiaries
  • Provide more than 200 covered professional services under the MPFS

Questions? Contact the Quality Payment Program at 1-866-288-8292 or at: QPP@cms.hhs.gov.

For more detailed information and updates about MACRA, MIPS and QPP, please use these tools to help you succeed under MACRA.

 

2020 Quality Payment Program Toolkit (PPT)

 

Overview of MIPS 2020 Performance (PDF)

 

MIPS Value Pathways Overview Fact Sheet (PDF)

 

2020 MIPS Value Pathways Overview

 

2020 Quality Payment Program Executive Summary

 

2020 Quality Payment Program Final Rule Fact Sheet (PDF)

 

MIPS Value Pathway Diagram (PDF)

 

MIPS Value Pathways: Surgical Example (PDF)

 

MIPS Value Pathway: Diabetes (PDF)

Overview of MIPS 2020 Performance Period Webinar (watch)

 

MIPS Value Pathways Public Webinar (watch)

 

 

 

2020 Quality Payment Program Final Rule Webinar (watch)

 

More information

SIR has compiled a list of frequently asked questions to provide members with the most beneficial information available on the MACRA transition.

Frequently asked questions about MACRA

Frequently asked questions about standardized reports

If you have questions, comments, or suggestions about additional tools, please contact Miata Koroma, SIR Director of Economics & Practice Development.