Q&As and Articles

Review articles and Q&A documents on various Quality Payment Program (QPP) topics.

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In addition to extending the data submission window, the Centers for Medicare & Medicaid Services (CMS) has re-opened the Merit-based Incentive Payment System (MIPS) Extreme and Uncontrollable Circumstances (EU&C) exception application due to the COVID-19 Public Health Emergency.


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Date Added: 04/14/2020
Date Last Modified: Apr 14 2020 1:57PM

Merit-based Incentive Payment System (MIPS)-eligible clinicians are eligible for facility-based measurement for a MIPS payment year if they are determined to be facility-based as an individual clinician or as part of a group. This article discusses eligibility and actions steps for using these measures to report MIPS.


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Date Added: 01/20/2020
Date Last Modified: Jan 20 2020 3:28PM

In 2019, clinicians are required to use 2015 Edition certified electronic health record technology (CEHRT) for the Promoting Interoperability category of the Merit-based Incentive Payment System (MIPS). The Centers for Medicare & Medicaid Services (CMS) require clinicians to include their CMS CEHRT ID when reporting. Use this guide to find your number.


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Date Added: 11/19/2019
Date Last Modified: Nov 20 2019 7:55AM

Typically patient portals require an email for a patient to create an account. If the patient or a family member does not have an email account to use for the patient portal, you can help them create one by converting their cellphone to an email address.


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Date Added: 04/15/2020
Date Last Modified: May 18 2020 11:08AM

This article explains how Medicare Annual Wellness Visit (AWV) activities apply to MIPS categories.


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Date Added: 03/27/2020
Date Last Modified: May 18 2020 11:24AM

Chronic care management is a critical component of primary care that contributes to better outcomes and higher satisfaction for patients with two or more chronic conditions. Read this questions and answer document to learn more.


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Date Added: 04/02/2020
Date Last Modified: May 18 2020 11:54AM

The Centers for Medicare & Medicaid Services (CMS) announced that Medicare would allow for expanded access to reimbursement for telehealth services as a result of the COVID-19 public health emergency. This expansion will help improve patient access to medical care, while minimizing requirements for patients to travel from their homes, and minimize burden on the overall health care system.


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Date Added: 04/02/2020
Date Last Modified: May 18 2020 11:54AM

CMS makes available the criteria used to audit and validate measures and activities for the Quality, Promoting Interoperability and Improvement Activities categories of MIPS. This article will guide you through what information you should retain in case of an audit.


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Date Added: 11/20/2019
Date Last Modified: Nov 20 2019 7:47AM

Coding encompasses more than just the claim codes used for reimbursement and quality data submission. This article addresses common questions regarding the use of coding for all collection methods for the Quality and Cost categories of the Merit-based Incentive Payment System (MIPS).


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Date Added: 05/13/2019
Date Last Modified: May 13 2019 11:30AM

The Merit-based Incentive Payment System (MIPS) has provided the same data submission mechanisms since it began in 2017. The guidance regarding reporting with more than one submission method has changed this year, and this article addresses those changes.


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Date Added: 08/06/2019
Date Last Modified: Feb 11 2020 2:01PM

The Quality category requirement for the Merit-based Incentive Payment System (MIPS) is to report six measures, with one being an outcome measure, or a high-priority measure if no outcome measures are available. The Single Source documents are available for both claims measure reporting and MIPS clinical quality measures (CQMs) (or registry) reporting. These are very helpful resources when you are choosing measures you may be able to report.


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Date Added: 07/01/2019
Date Last Modified: Feb 10 2020 1:54PM

Understanding Hierarchical Condition Categories (HCC) and their applicability to the Merit-based Incentive Payment System (MIPS) is important as clinicians work to receive recognition for the care they deliver to patients with complex conditions. Beneficiaries with complex health conditions may take additional time and resources to achieve positive health outcomes, and HCC helps recognize the complexity of that care.


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Date Added: 05/13/2019
Date Last Modified: May 13 2019 11:45AM

In 2019, seven new Merit-based Incentive Payment System (MIPS)-eligible clinician types were added: physical therapist, occupational therapist, speech-language pathologist, audiologist, clinical psychologist, and registered dietitian or nutritional professional. This Q&A article covers common questions from newly eligible clinician types.


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Date Added: 02/25/2019
Date Last Modified: Feb 25 2019 6:00AM

Even if you are an eligible clinician for the Merit-based Incentive Payment System (MIPS), you may qualify for a special status or hardship. This Q&A discusses questions regarding special status and hardships such as the electronic health record (EHR) exception.


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Date Added: 10/27/2019
Date Last Modified: May 18 2020 11:23AM

Even if you are an eligible clinician for the Merit-based Incentive Payment System (MIPS), you may qualify for a special status or hardship. This Q&A discusses questions regarding special status and hardships such as the electronic health record (EHR) exception.


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Date Added: 11/20/2019
Date Last Modified: May 18 2020 11:23AM

This article explains MIPS Special Status and Hardship exceptions.


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Date Added: 03/27/2020
Date Last Modified: May 18 2020 11:22AM

The Promoting Interoperability (PI) category of the Merit-based Incentive Payment System (MIPS) promotes patient engagement and the electronic exchange of information using certified electronic health record technology (CEHRT). The Centers for Medicare & Medicaid Services (CMS) has modified the PI category in 2019. This Q&A article answers frequently asked questions about PI.


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Date Added: 02/20/2019
Date Last Modified: Feb 20 2019 5:00AM

The Public Health and Clinical Data Exchange objective and its related measures have proven to be quite a challenge to many clinicians and their practices. This objective is now required to fulfill the Promoting Interoperability category requirements. This article will guide practices in how to meet this measure in the upcoming data submission.


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Date Added: 11/19/2019
Date Last Modified: Nov 19 2019 10:36PM

In 2019, the Merit-based Incentive Payment System (MIPS) requires 2015 Edition certified electronic health record technology (CEHRT) to be used for reporting both the Promoting Interoperability and Quality categories. This article answers common questions about using and updating 2015 Edition CEHRT effectively.


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Date Added: 05/14/2019
Date Last Modified: May 14 2019 11:00AM

CMS draws information from PECOS and NPPES to supply participants’ information for the Quality Payment Program (QPP). Based on information obtained from these systems, providers are tied to one or more tax identification numbers (TINs) for QPP eligibility and reporting, making accurate PECOS and NPPES data essential to having your information correct for QPP.


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Date Added: 11/19/2019
Date Last Modified: Nov 19 2019 10:40PM

This Merit-based Incentive Payment System (MIPS) reporting checklist will guide you through the data submission process. You should begin these steps as soon as possible, and before the end of the performance year.


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Date Added: 11/25/2019
Date Last Modified: Jan 16 2020 3:33PM

This article guides you through completing your Security Risk Analysis (SRA).


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Date Added: 12/09/2019
Date Last Modified: Dec 9 2019 12:25PM

The following telehealth information is based on regulations declared by the Secretary of Health and Human Services (HHS) on Jan. 31, 2020, and will be effective until the Secretary ends the COVID-19 Public Health Emergency.


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Date Added: 05/22/2020
Date Last Modified: May 22 2020 4:05PM

The Medicare Annual Wellness Visit (AWV), including Personalized Prevention Plan Services (PPPS), is an excellent way to perform needed services and capture Merit-based Incentive Payment System (MIPS) Quality measure data at the same time.


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Date Added: 11/20/2019
Date Last Modified: Nov 20 2019 8:38AM

The TMF MIPS Toolbox User Guide provides step-by-step guidance on how to use the Toolbox to prepare and report for the Merit-based Incentive Payment System (MIPS).


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Date Added: 12/02/2019
Date Last Modified: Feb 11 2020 9:00AM

Your electronic health record (EHR) system is an important tool in reporting your Merit-based Incentive Payment System (MIPS) data. This article provides a list of questions to consider asking your vendor to ensure you have the support you need to report MIPS.


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Date Added: 01/07/2020
Date Last Modified: Jan 7 2020 7:29AM