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MIPS Questions and Answers
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MIPS Questions and Answers True or False: Getting a sense of whether you're MIPS-eligible will be difficult until after January 2019. False. CMS has a QPP participation lookup webpage available right now. While it's true that CMS will update it to reflect the changes coming in 2019, you can prepa...

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  • January 2, 2025
  • 2
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

Subjects

  • mips questions and answers
  • pts in private practice who exceed the cms low vo
  • true or false group practices can participate in

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  • PTS
  • PTS

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MIPS Questions and Answers
True or False: Getting a sense of whether you're MIPS-eligible will be difficult until after
January 2019. - answer False. CMS has a QPP participation lookup webpage
available right now. While it's true that CMS will update it to reflect the changes coming
in 2019, you can prepare yourself for possible participation by checking to see if you
exceeded the participation thresholds in 2018.

PTs in private practice who exceed the CMS "low-volume threshold" of more than
$90,000 in allowed charges per year, more than 200 unique Medicare patients per year,
and more than 200 professional services delivered per year must participate in MIPS or
face a payment reduction of how much? - answer 7% (C). If you treat Medicare Part
B patients and meet all 3 low-volume threshold criteria and don't participate in MIPS in
2019, prepare for a 7% reduction in payment rates beginning in 2021. On the other
hand, successful participation in MIPS could result in an upward adjustment of as much
as 7%—in fact, it's the only factor on which CMS will be basing increases

True or False: PTs who don't meet the low-volume threshold are barred from
participating in MIPS. - answer False. You can opt in to the program beginning in
2019 if you treat Medicare Part B patients and meet any of the 3 criteria. You can opt in
on the QPP website in early 2019 for the 2019 participation year. Check out this
decision tree to better understand your options, and remember that once you opt in
you're obligated to participate the whole year.

True or False: Group practices can participate in MIPS only if every clinician in the
practice meets the low-volume threshold. - answer False. For group practices, the
threshold criteria (charges, unique Medicare patients, number of professional services)
are calculated at the group level—and across services delivered, not just physical
therapy.

True or False: Beginning in 2019, claims-based reporting will be permitted only in
practices with 15 or fewer MIPS-eligible clinicians. - answer True. Practices with
more than 15 clinicians will need to use a vendor to report data.

Which of the following statements is the best advice for PTs and practices considering
reporting through a vendor or registry to meet MIPS requirements?

A. Hold off for now. MIPS is still in flux and it's hard to predict which arrangements will
work.
B. Don't bother. Using an electronic health record (EHR) program alone will get the job
done.
C. You missed your chance. At this point, it's too late to integrate with a reporting
vendor or registry—your best bet is to go it on your own.

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