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TIP: Understand how your practice size affects your reporting requirements and scoring.

Following advocacy from ASCRS and the medical community, CMS has made accommodations to help small practices to succeed in MIPS. For the Quality and Improvement Activities categories, practices with 15 or fewer Medicare providers are subject to eased scoring requirements. In the Quality category, small practices must report on 6 quality measures, one of which must be an outcome measure or a high priority measure if no outcome measure is available, and will be scored out of a possible 60 points. For larger practices of 16 or more Medicare providers, CMS will also calculate an “all-cause hospital readmission measure” through Medicare claims, and score the category out of a possible 70 points. However, only practices that have 200 attributed patients will have the measure calculated and incorporated in the score. For the Improvement Activities category, ophthalmologists who practice in groups of 15 or fewer are only required to complete one high-weighted or two medium-weighted activities for full credit—40 points—for the category. For larger practices, high-weighted activities are worth 20 points, and medium-weighted activities are worth 10 points. Therefore, larger practices must complete a greater number of activities (in any combination of weights) to achieve full credit for the category. Click here for full details of the Quality category and the Improvement Activities category.

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