The Merit-Based Incentive Payment System: Mips Scoring Methodology Overview - Centers For Medicare & Medicaid Services Page 48

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Special Cases
What if a clinician changed groups after the performance period?
Performance follows the NPI
•
If the NPI worked for 1 TIN in performance period, then eligible clinician’s adjustment
•
will be based on the old TIN/NPI CPS
If the NPI worked for more than 1 TIN, we would take the weighted average of the
•
TIN/NPI scores
If the NPI did not have a score (because they did not bill claims), then the NPI is not in
•
MIPS (Excluded due to low-volume in performance period or being newly enrolled)
What if an EP has more than one submission?
Example: Multiple APM submissions; an APM, group submission, individual
•
submission
Proposal:
Take APM scores over other scores. If multiple APM CPS, take the highest scores
•
If no APM score – take the highest remaining score.
•
48

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