BillerBay's dedicated MIPS Consulting division streamlines the entire program life cycle for you, from eligibility to data submission. We help you select quality measures, train on reporting requirements, provide follow-ups, and simplify MIPS, enabling you to focus on delivering quality patient care.

The Medicare Access and CHIP Reauthorization Act (MACRA) establishes a new pay-for-performance program, incentivizing care quality over volume. MACRA's Quality Payment Program (QPP) offers two tracks to reimbursement: Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs).

MIPS is a performance-based adjustment program that consolidates three existing programs (Meaningful Use, Physician Quality Reporting System, and Value-Based Modifier) and adds a new component called Improvement Activities. Data collected annually affects Medicare payment adjustments.

Providers billing over $90,000 a year in allowed charges for covered professional services under the Medicare Physician Fee Schedule (PFS) and meeting other criteria are eligible for MIPS. Qualifying APM participants, providers with a minimum volume threshold of patients or payments, or providers in their first Medicare Part B enrollment year are exempted.

Eligible clinicians are scored annually in four performance categories: Quality, Cost, Promoting Interoperability, and Improvement Activities. Clinicians can participate as individuals or groups, with payment adjustments applied accordingly.

Leverage BillerBay's experience in consulting and training providers to exceed quality program guidelines and comply with CMS audits. We integrate Quality Payment Program requirements into everyday workflows for easy compliance and maximized performance.

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