MIPS 2020 Requirements

MIPS is a program that regulates Medicare payment regulations. Eligible Clinicians will receive a bonus, an amendment, or payment penalty based on their performance score.

MIPS is currently in the 4th year, and the base score will be more challenging to accomplish.

The most ideal approach to improve your MIPS performance is to learn the 2020 MIPS requirements.

Eligibility Criteria

The following participants are qualified to apply and be a part of the MIPS program

  • Physician
  • Physician Assistant
  • Nurse Practitioner
  • Clinical Nurse Specialist
  • Certified Registered Nurse Anesthetist
  • Physical Therapist
  • Occupational Therapist
  • Qualified Speech-language Pathologist
  • Qualified Audiologist
  • Clinical Psychologist
  • Registered Dietitian or Nutrition Professionals

You also need to fulfill the requirements

  • More than $90,000 billing per annum
  • Provide professional healthcare services to over 200 patients per annum
  • Provide healthcare to over 200 patients per annum

If you do not meet these criteria you are not eligible to apply. Although if you meet one of the above-mentioned requirements, you can apply for MIPS. 

 Minimum points to avoid penalty

Since it started in 2017, CMS increased the base score bit by bit from 3 points to 15 then 30 points gradually increasing every year and its 45 points in 2020.

2020 Payment Modification

If you are qualified and don’t accomplish the minimum performance limit of the MIPS program, you could lose up to – 9% of your Medicare Part B payment. That would be applied to your schedule year 2022 installments. On the other side, you can gain up to 9% PLUS reward cash for top performers.

Category Requirements            

Each category of MIPS has requirements that you should meet to completely to qualify for incentives. That includes 4 categories.


Max-Points: 60 

 Worth: 45% of the total MIPS score

 Performance Period: 1 year


  • Report an aggregate of six Quality measures to CMS.
  • Submit in any event one Outcome measure except if there isn’t one accessible in your measure set. You can report another Top Priority measure in the replacement.
  • You can use multiple collection types to submit measures, i.e. eCQMs, MIPS CQMs, or QCDR.
  • To score your Quality measures meet at least 20-case.
  • 70% of all Eligible Clinician must be part of the measures.


Max-Points: 100 

 Worth: 25% of the total MIPS score

 Performance Period: 3 months (minimum)


  • Report measures from every one of the four targets. 
  • You must utilize EHR to the 2015 standard of CEHRT.
  • If you miss reporting on any required measures you will get zero scores in that category.
  • There will be an automatic zero-point distribution to these types, NP, PA, CRNA, CNS, PT, OT, Speech Pathologist, Audiologist, Clinical Psychologist, and Registered Dietitian.
  • If you want to participate you will be scored as per your performance in the categories and if you are applying as a group of clinicians then 75% of your group must meet the criteria.


Max-Points: 40

 Worth: 15% of the total MIPS score

 Performance period: 3 months (minimum)


  • Report Improvement Activity Measures to an aggregate of 40 points. 
  • Groups with 15 members have their points multiplied in this classification.
  • If submitting as a group 50% your group must attest to complete the improvement over 3 months


Worth: 15% of the total MIPS score

 Performance Period: 1 year


  • CMS will assess your performance on two measures: Medicare Spending per Beneficiary (MSPB) and Total Per Capita Cost. 
  • CMS will assess on the accompanying 18 scene based measures.

Reporting Choices

You have the choice to report as an individual or a group. You can also report as large practice or a virtual group although you have to inform CMS before taking part in any virtual group. 

MIPS 2020 Score Onset

Your scoreboard should show at least 45 points if you want to evade -9% forfeit.

For the incentive bonus, you must yield a score of 85 to be eligible for EP. 

  • 0-45 Points -If you don’t meet the 45-point, you can lose as much as – 9% from your 2022 Medicare expense plan.
  • 45-100 Points- Anybody whose MIPS score is somewhere in the range of 45 and 100 focuses will get some segment of those assets – up to a 9% extension to their 2022 Medicare charge plan.
  • If you score 85 points, you’ll be qualified for the Exceptional Performance reward cash. This is on the head of whatever bit of cash you get from the individuals who don’t take part.

You may begin between January 1 and October 2, 2020, to follow your measures for at least 3 months. 31st March 2021 is the last date to submit your performance.

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