House Doctors Caucus Calls on CMS to Raise MIPS Low-Volume Threshold to Increase Physician Eligibility Despite ASCRS and Medical Community Support for Current Low-Volume Threshold

This week, several members of the House Republican Doctors Caucus sent a letter to CMS requesting the MIPS low-volume threshold be raised in 2019 to make a greater number of Medicare providers eligible for the MIPS program. Currently, physicians are excluded from MIPS if they bill less than $90,000 in allowed Part B charges or see 200 or fewer patients. This level was increased from the 2017 threshold of $30,000 in allowed charges or 100 patients. ASCRS and the medical community supported increasing the low-volume threshold for 2018 as it would reduce the regulatory burden on physicians who do not see a high volume of Medicare patients. The Doctors Caucus letter contends that CMS has set the low volume threshold too high and excluded too many potential participants, which given that MIPS payment adjustments are budget neutral, limits the available amount of money to distribute as bonuses to high achievers. The letter requests CMS include a proposal to raise the low-volume threshold in the 2019 Medicare Physician Fee Schedule proposed rule, which is expected to be released shortly. We will keep you updated.