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MIPS 2021
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MIPS 2021 Final Rule: Overview

In response to the nationwide Public Health Emergency (PHE) caused by the COVID-19 pandemic, CMS is focusing on policies related to the Quality Payment Program (QPP) for 2021. Consequently, the Merit-based Incentive Payment System (MIPS) 2021 aims to impose minimal burdens on eligible clinicians (ECs).

MACRA MIPS and Advanced Alternative Payment Models (APMs) are key components in this context. To advance beyond MIPS 2020, the government is actively developing the MIPS Value Pathways (MVPs) framework, finalizing fundamental principles, and enhancing stakeholder understanding. The introduction of this novel framework necessitates collaboration with CMS for a comprehensive grasp.

Additionally, reporting requirements for the Advanced APM track in 2021 have been streamlined, reducing the reporting burden. As a trusted third-party intermediary and a Qualified Registry for five consecutive years, we are well-prepared to facilitate reporting for clinicians, ensuring a smoother process this year.

While most submission processes remain similar to those in 2020, a notable change is observed regarding APM entities. They are no longer evaluated based on low-volume thresholds. Thus, individual or group eligibility is required for clinicians participating in MIPS APMs. If you find yourself pressed for time, rest assured that Avant Garde understands the 2021 MIPS requirements thoroughly and is ready to provide seamless support.


MIPS Reporting 2021 Eligibility Criteria

To be eligible, you must:

  • Bill more than $90,000 annually for covered medical services.
  • Provide services to more than 200 Medicare Part B patients.
  • Offer more than 200 covered services under the Physician Fee Schedule (PFS).



How to Report MIPS Data in 2021?

The process for reporting MIPS data remains unchanged from 2020. In 2021, you can effectively report MIPS measures through the following methods:

  • CMS Web Interface
  • Qualified Registry
  • Qualified Clinical Data Registry (QCDR)
  • Medicare Part B Claims
  • CAHPS for MIPS Reporting


MIPS 2021 Key Points

  • The performance threshold has increased to 60 from 45 points, as determined in the CY 2020 Quality Payment Program (QPP) Final Rule.
  • The Quality category carries a weight of 40% (a 5% decrease).
  • The Cost category carries a weight of 20% (a 5% increase).
  • The Promoting Interoperability (PI) category carries a weight of 25% (no change).
  • The Improvement Activities (IA) category carries a weight of 15% (no change).

Unmatched Bonuses in MIPS 2021 for Physicians

With MIPS 2021 introducing new compliance scores, it aligns with the benefit of clinicians at all levels. Ensuring compliance with MIPS 2021 requirements is essential to stay on the right track. Program changes or updates can occur, making it prudent to review the 2021 requirements. As a MIPS consultancy, Avant Garde remains well-informed about the MIPS Quality measures for each clinician. We are eager to make this year another successful one for you. Let us collaborate to safeguard your financial and reputational integrity through accurate reporting.

The administrative load of MIPS 2021 reporting is the most challenging part, but we will take care of it.