To avoid a payment penalty in 2024, based on MIPS performance in 2022, surgeons must earn 75 MIPS overall points. MIPS participants who exceed the separate exceptional performance threshold, which has been set at 89 points for 2022, are eligible for an additional positive payment adjustment from a separate pool of funding. However, 2022 is the last performance year that funding will be available for exceptional performance bonuses. This is an important point since the exceptional performance pool of funding has made up the bulk of positive payment adjustments received by clinicians to date.
In the past, you could still meet the performance threshold without meeting the reporting requirements for all four MIPS performance categories, but this is no longer the case due to a higher performance threshold and changes to the performance category weights. The ACS recommends that you plan to fully report for the three reportable MIPS performance categories—Promoting Interoperability, Quality, and Improvement Activities categories (Cost is calculated by CMS) to have the best chance of avoiding a possible negative payment adjustment for the 2024 payment year. Please note: As a reminder, the payment adjustment for 2024 is set at -9 percent.
In 2022, CMS will be extending the opportunity to apply for a COVID-related hardship exemption for up to four MIPS performance categories. The extension of this policy will likely mean that upward payment adjustments for high performers will remain low.
CMS also offers many resources on their Quality Payment Program website and is a great resource for learning about and selecting Quality measures, Promoting Interoperability measures, and Improvement Activities for reporting in 2022.
See the attachment below for more information on how to avoid a penalty: