Eligible clinicians who submitted 2017 Quality performance data for the Merit-Based Incentive Payment System (MIPS) via claims can view performance scores through the MIPS data submission feature on the Quality Payment Program (QPP) website. Note: claims data submission is only an option if you’re participating in MIPS as an individual, not as part of a group.
Submitting Quality Performance Data via Claims
No additional action is needed for quality data submitted via claims, as they are automatically calculated by the Centers for Medicare & Medicaid Services (CMS) based on the Quality Data Codes (G-codes) submitted on 2017 claims. To view calculated individual measures and category scores for Program Year 2017, login to qpp.cms.gov.
Scoring of claims data is subject to change monthly based on the processing of any additional 2017 claims and adjustments up to 90 days after the end of 2017. It is possible that claims or adjustments that were submitted towards the end of 2017 have not yet processed. Physicians can check back after March 31st, 2018 for final scores.
Still Time to Submit Claims for 2017
Physicians that want to submit any outstanding 2017 claims that they’d like factored in to the Quality performance category should submit them now. Claims, which are processed by Medicare Administrative Contractors (MACs), including claims adjustments, re-openings, or appeals must get to the national Medicare claims system data warehouse (National Claims History file) by March 1, 2018 to be analyzed. For instructions on how to bill, visit MACs.
To prepare for 2017 submission, review the following resources on the Quality Payment Program website:
- MIPS Claims Data Submission Fact Sheet
- MIPS Data Submission Video
- MIPS Data Submission Fact Sheet
- QPP Service Center (Call: 1-866-288-8292 or TTY: 1-877-715-6222; Email: firstname.lastname@example.org)
Click here for a demonstration on the new qpp.cms.gov feature.