Background
The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) repealed the broken Medicare sustainable growth rate (SGR) formula and established new payment pathways for physicians. To implement MACRA's reimbursement reforms, the Centers for Medicare & Medicaid Services (CMS) developed the Quality Payment Program which includes:
- The Merit-based Incentive Payment System (MIPS), as a modifier for fee-for-service payments beginning in 2019.
- Alternative Payment Models (APMs).
Making Sense of QPP
MIPS Eligibility and Preparedness
Individual pathologists and group practices can now check their eligibility for the MIPS performance year by using the CMS’ Quality Payment Program (QPP) lookup tool. The CAP also provides resources to help pathologists comply as the CMS implements and administers MIPS and APM programs.
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Confirm your MIPS status
Are you eligible to participate in MIPS?
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Access the checklist
Optimize your performance in MIPS
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View the options
Understand your reporting options
Impact Calculator
Use our MIPS calculator to estimate future Medicare payment adjustments using your practice data and project the impact to your bottom line.
Pathologists Quality Registry
The Pathologists Quality Registry can improve practice performance, through benchmarking against other pathology practices, and make it easier for pathologists to qualify for bonuses under MIPS. If you would like information on our Pathologists Quality Registry, our qualified clinical data registry, complete the inquiry form to schedule a call with a member of our registry team.
How to Comply with MIPS
Pathologist Quality Measures
Identify relevant measures to help avoid Medicare payment penalties and earn bonuses when reported correctly.
Improvement Activities
Clinicians need to attest to Improvement Activities (IA), which represent 15% of a pathologist’s MIPS score, to receive credit in this category. Read answers to IA questions to learn all you need to know about Improvement Activities.
Members may login to access Improvement Activities we have identified as applicable to pathologists participating in MIPS.
MIPS Webinars
To help pathologists successfully navigate the new and evolving payment models, the CAP launched a series of 30-minute webinars. During each session, recognized CAP experts explain the components MIPS and how to successfully comply with MIPS requirements.
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2020 Final Medicare Payment for Pathologists Webinar
November 1, 2019
The CMS released of the final 2020 Medicare Physician Fee Schedule and the Quality Payment Program regulations on November 1. CAP experts Chair of the Council on Government and Professional Affairs Jonathan Myles, MD, FCAP; Chair of the Economic Affairs Subcommittee W. Stephen Black-Schaffer MD, FCA; and Co-Chair of the Economic Affairs Subcommittee Diana Cardona, MD, FCAP.
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2019 MIPS Facility-Based Overview
June 21, 2019
During this 30 minute on-demand presentation, Emily E. Volk, MD, FCAP, reviews the new facility-based scoring options for pathologists in the 2019 Merit-based Incentive Payment System (MIPS).
Additional Resources
CAP Resources
AMA Resources
CMS Resources
2019 MIPS Webinar Series
Contact Information
We have a dedicated team to help you navigate to MIPS reporting success.
Email: mips@cap.org
Phone: 800-323-4040, option 3