2021 New Year FAQ: MIPS

As we get ready to ring in 2021, here are some common MIPS questions and answers to help your clinic easily transition into the new year. Check out the EMR FAQ article for more information regarding changes coming in 2021.

Why is my MIPS tab missing? I saw it the other day. 

The MIPS platform will automatically reset on January 1st and requires MIPS to be repurchased and setup. Until MIPS 2021 is enabled (estimated availability is late January 2021), you will only see the MIPS tab on notes with a date of service in 2020. For backdated notation, the date in new notes must be set to a 2020 date of service, saved as a draft, and re-opened for the MIPS tab to appear.

When do I need to submit my 2020 scores?

The submission deadline is March 31, 2021.  Each practice is responsible for reviewing their account, ensuring it is complete and accurate, and then indicating they are ready to submit. Healthmonix will directly communicate with Members to get their data ready. Members will need to click a submit button which will act as a digital signature to approve the data. Healthmonix will queue the data and submit it as a total sum of all of our Members’ MIPS data. 

For WebPT Member practices enrolled in our MIPS Portal:

  • Healthmonix, our registry partner, will send an email to each individual identified as an administrator in your portal account.
  • The email will: 
    • Alert you that CMS is ready to accept registry data for MIPS 2021 reporting;
    • Ask you to review your quality measure data to ensure it looks accurate and complete; and
    • Remind you to attest to your improvement activities.
  • When you are satisfied that everything in your account is in order, one of the practice administrators will click a Submit button in the portal, and data submission to CMS will commence.
What is the Extreme and Uncontrollable Circumstances Exception?

This exception policy allows you to request reweighting for one or more MIPS performance categories (i.e. Quality Measures or Improvement Activities). If you believe you have been affected by an extreme and uncontrollable circumstance or public health emergency, we recommend submitting an application. Learn more about the Exception Application here.

How do I apply for the Extreme and Uncontrollable Circumstances Exemption?

Click here for instructions on submitting an application. The deadline to complete an application has been extended to March 31, 2021 at 8 PM EST. 

Where can I see my 2019 performance feedback?

Register for a HARP account to access your performance feedback, report data, and manage users. Click here for an instructional guide. 

When will I be able to look up my eligibility for 2021?

Use the Healthmonix MIPS Eligibility Lookup Tool to determine the MIPS eligibility status for up to 100 NPIs at one time for the selected performance year.

All you need to do is type in your NPI; then, Quality Payment Program (QPP) will pull your information from the most recent 12-month determination period and tell you whether or not you’re required to participate in MIPS.

Is the performance threshold increasing?

Yes. MIPS participants must obtain 60 points or more to avoid a negative payment adjustment. This is up from the 45 points required in 2020. The additional performance threshold for exceptional performance will remain at 85 points. 

Has the MIPS payment adjustment changed?

The MIPS payment adjustments will remain at +/-9%. Eligible MIPS participants who do not report 2021 MIPS data will receive a -9% MIPS penalty against their 2023 Medicare Part B payments for covered professional services.

Are there any changes to MIPS quality measure requirements?

CMS requires all MIPS participants to have 70% data completion on all their measures, this is the same as the 2020 performance period. Additionally, CMS finalized the following measure changes:

Added to the PT/OT specialty set:

  • 283: Dementia Associated Behavioral and Psychiatric Symptoms Screening and Management
  • 286: Dementia: Safety Concern Screening and Follow-Up for Patients with Dementia

Removed from the PT/OT specialty set:

  • 282: Dementia: Functional Status Assessment

Added to the SLP measure set:

  • 134: Preventative Care and Screening: Screening for Depression and Follow-up Plan
Are any changes to the Improvement Activities?

No. CMS requires 50% of the reporting group members to complete each activity in order for the group to attest to its completion. 

Are there any changes to the Low-Volume Threshold?

CMS did not propose or finalize any changes to the low-volume threshold for 2021. Essentially, that means a large majority of PTs, OTs, and SLPs will not be mandated to participate in MIPS next year.

Do I need to do anything if I added anyone to my MIPS group/providers mid-year?

If you are reporting as a group, or you acquired a therapist who is reporting individually for this year, you will need to make sure this person is set up in Healthmonix. Please email support@webpt.com including the following information:

  • Provider Name
  • NPI Number
I'm not mandated to report. What happens if I opt-in to MIPS?

If you elect to opt-in to MIPS, you will receive performance feedback, as well as a MIPS payment adjustment. Click here to learn more about opting-in as an individual for MIPS.

I'm not mandated to report. What happens if I voluntarily report data to MIPS?

If you voluntarily report, you will receive performance feedback only. Click here to learn more about voluntary reporting data.

What if I need to add another license in Healthmonix?

Please send an email to MVT-sdr@webpt.com and include that you are needing an additional Healthmonix license specifically.

Why is my MIPS tab missing? I saw it the other day. 

The MIPS platform will automatically reset on Jan 1. You will only see the MIPS tab on notes with a date of service in 2020 once you are set up for MIPS 2021.

When can I purchase MIPS for 2021?

We will begin selling MIPS on January 1, 2021.

Is WebPT going to do a webinar once the Final Rule is announced? How can I sign up?

Join us for a live webinar at 9:00 AM PST on Thursday, December 17th, 2020. Sign up here.