MIPS Eligibility Lookup Tool: 2020 Data Now Available & 2019 Data Corrected

2020 MIPS Eligibility Data Now Available

The Centers for Medicare and Medicaid Services (CMS) have updated the Quality Payment Program Participation Status Lookup Tool to include initial provider eligibility status for the 2020 performance year. Providers can enter their National Provider Identifier number to determine their eligibility status. The tool is available here.

Not all physicians will be eligible to participate in the Merit-based Incentive Payment System (MIPS), however, providers not meeting all the eligibility criteria may choose to opt-in to receive payment adjustments or voluntarily report to MIPS. Additional information about eligibility criteria can be found here.

2019 MIPS Data Eligibility: CMS Corrects Data Inconsistencies

CMS identified inconsistencies with the final update of 2019 MIPS eligibility data and is recommending that clinicians, who checked their eligibility status after December 4, recheck their final eligibility status as it may have changed. Clinicians can log in through the Quality Payment Program webpage to determine if they are eligible.

With the final review of eligibility data for participation in MIPS, certain clinicians who were previously eligible for MIPS may have a change in their eligibility status after the final review. However, those who were exempt from MIPS during the initial eligibility review will remain exempt after the final review.

Eligible clinicians are required to submit data online to CMS by March 31, 2020. Additional information about MIPS eligibility and data reporting can be found on the MIPS homepage as well as the QPP Resource Library.



For more information visit the McDermottPlus Payment Innovation Resource Center or contact Sheila Madhani at 202-204-1459 or smadhani@mcdermottplus.com.