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CMS Releases Facility-based Scoring Preview

For the 2019 performance year, the Merit-based Incentive Payment System (MIPS) includes the option to use facility-based measurement for the Quality and Cost performance categories for MIPS eligible clinicians, groups, and virtual groups who are determined to be facility-based. These clinicians will be assessed based on their performance in hospital settings.

To determine if you’re facility-based, the Centers for Medicare & Medicaid Services (CMS) will look at your Medicare Part B claims billed between October 1, 2017 and September 30, 2018 (including a 30-day claims run out). You are considered facility-based if you are a MIPS eligible clinician type and you:

  1. Billed at least 75 percent of your covered professional services in a hospital setting;
  2. Billed at least one service in an inpatient hospital or emergency room; and
  3. Can be attributed to a facility with a Hospital Value-based Purchasing (VBP) score

To determine if you qualify for facility-based scoring, check the QPP Participation Status Tool and read facility-based preview FAQs.

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