2022 New Year FAQ: MIPS

As we get ready to ring in 2022, here are some common MIPS questions and answers to help your clinic easily transition into the new year. 

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 2022 is enabled (estimated availability is early January 2022), you will only see the MIPS tab on notes with a date of service in 2021. For backdated notation, the date in new notes must be set to a 2021 date of service, saved as a draft, and re-opened for the MIPS tab to appear.

When do I need to submit my 2021 scores?

The submission deadline is March 31, 2022. Healthmonix will directly communicate with Members to get their data ready. Each practice is responsible for reviewing their account, ensuring it is complete and accurate, and then indicating they are ready to submit. Members will need to click a submit button which acts 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 2022 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 your practice administrators must click  Submit within the portal to begin data submission to CMS . 
  • For questions or assistance with submitting your 2021 MIPS data, please contact Healthmonix Support:

Contact Healthmonix

What is the Extreme and Uncontrollable Circumstances Exception (EUC)?

This exception policy allows you to request reweighting for one or more MIPS performance categories (i.e., Quality Measures or Improvement Activities). If you are an individual MIPS-eligible clinician who is mandated to report for the program (or if you opted in earlier this year), you are now automatically opted out of the program unless you specifically choose otherwise. This means you:

  • Do not have to continue collecting quality measures data; 
  • Do not have to complete your final improvement activity; and 
  • Do not have to submit your data for the 2021 performance year.
Where can I learn more about the Extreme and Uncontrollable Circumstances Exemption?

To learn more about the Extreme and Uncontrollable Circumstances policy, click here.

Where can I see my 2020 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 2022?

MIPS Eligibility Lookup tools will be updated for the 2022 Performance Period in Late November to Early December. We will communicate when these tools become available. 

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. If you’re looking up one NPI, you can also use the Quality Payment Program’s Participation Status Lookup

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 75 points or more to avoid a negative payment adjustment. The additional performance threshold for exceptional performance is increasing to 89 points. Furthermore, 2022 will be the final year for the additional performance threshold. 

Has the MIPS payment adjustment changed?

The MIPS payment adjustments will remain at +/-9%. Mandated MIPS participants who do not report 2022 MIPS data will receive a -9% MIPS penalty against their 2024 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 2021 performance period. Additionally, CMS finalized the following measure changes:

Removed from the PT/OT specialty set:

  • 154: Falls: Risk Assessment

There are also changes coming to how some measures are reported. Healthmonix measures 4, 5, 6, and 8 have been replaced by Intermountain ROMS (IROMS) Measures 19, 15, 17, and 13 respectively. While the way these measures are documented will remain largely the same, it’s important to note that these measures are referred to as “Inverse Measures”. This means that a lower calculated performance rate for this measure indicates better clinical care or control.

Are any changes to the Improvement Activities?

Yes. CMS is deleting some “duplicative” Improvement Activities:

  • IA_BE_13: Regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms.
  • IA_BE_20: Implementation of condition-specific chronic disease self-management support programs.
  • IA_BE_21: Improved practices that disseminate appropriate self-management materials.
Are there any changes to the Low-Volume Threshold?

CMS did not propose or finalize any changes to the low-volume threshold for 2022. Essentially, that means a large majority of PTs, OTs, and SLPs will not be mandated to participate in MIPS next year. Check your participation status by going to qpp.cms.gov.

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 if you acquired a therapist who is reporting individually for this year, you’ll 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 to request an additional Healthmonix license.

When can I purchase MIPS for 2021?

We will begin selling MIPS on January 1, 2022.

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 Tuesday, December 14th, 2021. Sign up here.

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