Help Has Arrived

For Physicians and Practices Determining Their Exemption from MIPS

If you are unsure whether you as a physician, clinician or medical practice are exempt from participating in the MIPS track of the Quality Payment Program, help has arrived.  CMS has now launched a tool on their website so that you can determine your exemption confidently.

To determine your status, enter your national provider identifier (NPI) into the entry field on the tool which can be found on the Quality Payment Program website at Information will then be provided on whether or not you should participate in MIPS this year and where to find resources.

Here are some quick tips from Main Street Medical Consulting before getting started on the CMS website

You will participate in MIPS in 2017 if you or your practice:

  • Bill Medicare Part B more than $30,000 a year AND
  • See more than 100 Medicare patients a year.

You must also be a:

  • Physician
  • Physician assistant
  • Nurse practitioner
  • Clinical nurse specialist
  • Certified nurse practitioner


If you or your practice are new to Medicare in 2017, you do not participate in MIPS. You may also be exempt if you qualify for one of the special rules for certain types of clinicians, or are participating in an Advanced Alternative Payment Model (APM). To learn more, review the MIPS Participation Fact Sheet.                                                               

If you are not in the program in 2017, you can participate voluntarily and you will not be subject to payment adjustments.  

Additional Resources

Participation Notification Letters – CMS recently sent letters in the mail notifying clinicians of their MIPS participation status. See a sample of the letter on the Education page of  this tool is another resource for clinicians to use to determine their status.

Medicare Provider Experience Survey Sample – CMS has published an example of a patient feedback survey to help practitioners determine their performance from patients before submitting information as part of their participation in MIPS.  This survey is to help serve as the basis for medical providers to form their own surveys relevant to their patient’s specific needs, and gauge the patient’s perception of provided care.

CMS Approved Quality Clinical Data Registries – A list of CMS approved data registries.  QCDRs are approved reporting mechanisms for participation in MIPS programs. CMS has compiled a list of the different mechanisms that they have approved for programs, practices, and healthcare providers participating in MIPS to help determine whether your current mechanisms qualify.