Notice: This HH S-approved document has been submitted to the Office of the Federal Register (OFR) for publi cation and has not yet been placed on publi c display or publi shed i n the Federal Register. This document may vary sli ghtly f rom the of f i cial publi shed document if minor editorial changes have been made during the OFR review process. The document publi shed i n the Federal Register i s the of f i cial HH S-approved document. I f you need to access the i nformation i n this document with assistiv e technology, please email W esley.W ei@cms.hhs.gov. TABLE 60: MIPS ESTIMATED PAYMENT YEAR 2019 IMPACT ON TOTAL ALLOWED CHARGES BY SPECIALTY, STANDARD PARTICIPATION ASSUMPTIONS * Clinician Specialty/Type Number of Allowed MIPS Eligible Clinicians Charges (mil) TIN/NPIs Percent Percent Percent Aggregate Aggregat Aggregat Aggregate Eligible Eligible Eligible Positive and e Positive e Impact Impact Clinicians Clinicians Clinicians (TIN/NPIs) (TIN/NPIs) (TIN/NPIs) engaging with with Positive with quality or Negativ data Neutral submission MIPS ** Payment e MIPS Payment Adjustmen Adjustmen t MIPS Positive Negativ Payment MIPS MIPS e MIPS Adjust-ment, Exceptional Payment Payment Payment Performance Adjustment, Payment Only Adjustme Adjustment (mil) (mil)* Excluding nt Neutral Exceptional mil Performance ) Net Impact of MIPS Net Impact of MIPS Payment Adjustments (mil)** Payment Adjustments as Percent of Allowed Changes** Payment t (mil) ALL MIPS ELIGIBLE CLINICANS SUBJECT 592,119- $76,598- TO DATA SUBMISSION 642,119 $81,380 REQUIREMENTS*** ALL SPECIALTIES 676,722 $78,454 94.7% 94.7% 5.3% $199 $500 $699 -$199 $500 0.6% 2,389 $251 92.1% 92.1% 7.9% $1 $2 $2 -$1 $1 0.4% Anesthesiology 29,845 $1,982 95.7% 95.7% 4.3% $4 $8 $11 -$5 $6 0.3% Cardiology 24,657 $5,172 95.0% 95.0% 5.0% $15 $40 $54 -$11 $43 0.8% Chiropractic 4,485 $247 87.8% 87.8% 12.2% $0 $1 $1 -$1 $0 0.0% 1,267 $46 91.0% 91.0% 9.0% $0 $0 $0 $0 $0 0.1% 1,170 $125 96.3% 96.3% 3.7% $0 $1 $1 $0 $1 0.8% 2,560 $257 93.8% 93.8% 6.2% $1 $2 $2 -$1 $1 0.5% 447 $16 94.2% 94.2% 5.8% $0 $0 $0 $0 $0 0.4% 10,328 $2,960 92.1% 92.1% 7.9% $8 $16 $24 -$8 $16 0.5% 41,687 $2,722 97.3% 97.3% 2.7% $5 $8 $13 -$3 $10 0.4% (SCORING MODEL) Allergy/Immunology Clinical Nurse Specialists Colon/Rectal Surgery Critical Care Dentist Dermatology Emergency Medicine 1 5,065 $474 96.4% 96.4% 3.6% $1 $4 $5 -$1 $4 0.9% 71,073 $5,802 95.0% 95.0% 5.0% $16 $45 $62 -$15 $46 0.8% Gastroenterology 12,168 $1,595 95.6% 95.6% 4.4% $4 $11 $16 -$3 $13 0.8% General Practice 2,389 $228 90.0% 90.0% 10.0% $0 $1 $2 -$1 $0 0.2% Endocrinology Family Medicine **** Notice: This HH S-approved document has been submitted to the Office of the Federal Register (OFR) for publi cation and has not yet been placed on publi c display or publi shed i n the Federal Register. This document may vary sli ghtly f rom the of f i cial publi shed document if minor editorial changes have been made during the OFR review process. The document publi shed i n the Federal Register i s the of f i cial HH S-approved document. I f you need to access the i nformation i n this document with assistiv e technology, please email W esley.W ei@cms.hhs.gov. Clinician Specialty/Type Number of Allowed MIPS Eligible Clinicians Charges (mil) TIN/NPIs Percent Percent Percent Aggregate Aggregat Aggregat Aggregate Eligible Eligible Eligible Positive and e Positive e Impact Impact Clinicians Clinicians Clinicians (TIN/NPIs) (TIN/NPIs) (TIN/NPIs) engaging with with Positive with quality or Negativ data Neutral submission MIPS ** Payment e MIPS Payment MIPS Positive Negativ Payment MIPS MIPS e MIPS Adjust-ment, Exceptional Payment Payment Payment Performance Adjustment, Payment Only Adjustme Adjustment (mil) Excluding (mil)* nt Exceptional mil Performance Neutral Payment (mil) Net Impact of MIPS Net Impact of MIPS Payment Adjustments (mil)** Payment Adjustments as Percent of Allowed Changes** ) Adjustmen Adjustmen t t General Surgery 18,118 $1,734 94.5% 94.5% 5.5% $5 $12 $17 -$5 $12 0.7% Geriatrics 3,044 $371 94.0% 94.0% 6.0% $1 $3 $4 -$1 $3 0.7% Hand Surgery 1,769 $253 91.2% 91.2% 8.8% $1 $1 $2 -$1 $1 0.4% Infectious Disease 5,412 $684 94.1% 94.1% 5.9% $2 $4 $6 -$2 $4 0.6% Internal Medicine 80,871 $9,320 94.3% 94.3% 5.7% $26 $70 $95 -$25 $71 0.8% 1,886 $389 96.7% 96.7% 3.3% $1 $2 $2 -$1 $2 0.4% Nephrology 7,048 $1,598 94.3% 94.3% 5.7% $4 $11 $15 -$4 $11 0.7% Neurology 12,540 $1,405 94.4% 94.4% 5.6% $4 $9 $13 -$5 $8 0.6% Neurosurgery 4,470 $696 93.8% 93.8% 6.2% $2 $4 $6 -$2 $4 0.5% Nuclear Medicine 540 $98 95.0% 95.0% 5.0% $0 $1 $1 $0 $0 0.4% Nurse Anesthetist 23,892 $700 96.3% 96.3% 3.7% $1 $3 $4 -$2 $2 0.2% Nurse Practitioner 51,004 $1,763 95.4% 95.4% 4.6% $5 $12 $16 -$8 $8 0.5% Obstetrics/Gynecology 18,578 $487 97.3% 97.3% 2.7% $1 $3 $5 -$1 $3 0.7% Oncology/Hematology 10,368 $4,747 95.3% 95.3% 4.7% $11 $28 $40 -$10 $30 0.6% Ophthalmology 16,502 $7,689 96.3% 96.3% 3.7% $23 $66 $89 -$5 $85 1.1% Optometry 12,116 $926 93.3% 93.3% 6.7% $2 $5 $7 -$2 $5 0.5% 129 $5 96.1% 96.1% 3.9% $0 $0 $0 $0 $0 0.7% Orthopedic Surgery 19,360 $3,286 92.0% 92.0% 8.0% $8 $18 $26 -$11 $15 0.4% Other MD/DO 10,764 $1,281 93.3% 93.3% 6.7% $3 $7 $11 -$5 $6 0.5% Otolaryngology 7,812 $969 93.4% 93.4% 6.6% $2 $5 $8 -$3 $4 0.5% Pathology 10,433 $1,020 96.0% 96.0% 4.0% $2 $4 $6 -$4 $2 0.2% Pediatrics 4,565 $59 99.0% 99.0% 1.0% $0 $0 $1 $0 $0 0.8% Physical Medicine 6,357 $997 90.9% 90.9% 9.1% $2 $5 $7 -$4 $3 0.3% Physician Assistant 42,402 $1,284 96.2% 96.2% 3.8% $3 $8 $11 -$4 $7 0.5% Intervention al Radiology Oral/Maxillofacial Surgery 2 Notice: This HH S-approved document has been submitted to the Office of the Federal Register (OFR) for publi cation and has not yet been placed on publi c display or publi shed i n the Federal Register. This document may vary sli ghtly f rom the of f i cial publi shed document if minor editorial changes have been made during the OFR review process. The document publi shed i n the Federal Register i s the of f i cial HH S-approved document. I f you need to access the i nformation i n this document with assistiv e technology, please email W esley.W ei@cms.hhs.gov. Clinician Specialty/Type Number of Allowed MIPS Eligible Clinicians Charges (mil) TIN/NPIs Percent Percent Percent Aggregate Aggregat Aggregat Aggregate Eligible Eligible Eligible Positive and e Positive e Impact Impact Clinicians Clinicians Clinicians (TIN/NPIs) (TIN/NPIs) (TIN/NPIs) engaging with with Positive with quality or Negativ data Neutral submission MIPS ** Payment e MIPS Payment MIPS Positive Negativ Payment MIPS MIPS e MIPS Adjust-ment, Exceptional Payment Payment Payment Performance Adjustment, Payment Only Adjustme Adjustment (mil) Excluding (mil)* nt Exceptional mil Performance Neutral Payment (mil) Net Impact of MIPS Net Impact of MIPS Payment Adjustments (mil)** Payment Adjustments as Percent of Allowed Changes** ) Adjustmen Adjustmen t t Podiatry 13,598 $1,800 87.7% 87.7% 12.3% $4 $8 $12 -$9 $3 0.2% Psychiatry 14,044 $864 86.2% 86.2% 13.8% $2 $5 $6 -$8 -$1 -0.1% Pulmonary Disease 9,910 $1,535 94.3% 94.3% 5.7% $4 $11 $15 -$4 $11 0.7% Radiation Oncology 3,364 $1,160 95.1% 95.1% 4.9% $3 $7 $10 -$3 $7 0.6% N otes: Standard scoring model assumes that a minimum of 90 percent95.3% of cli nicians 95.3% within each practice would participate in quali 34,613 $4,507 4.7% size category $9 $17 $27 ty data submission. -$10 $17 Radiology *2015 data used to estimate 2017 performance. Payments estimated using 2015 doll ars. 3,865 $1,353 96.4% 96.4% 3.6% $4 $10 $13 -$2 $12 Rheumatology * * The Net Impact to Payments i s the combined impact of negative and positive adjustments and the exceptional performance payment. Thoracic/Cardiac ** * T he estimated number of M IPS3,333 eli gible cli nicians reporting requirements are2.5% based on QP eli estimates. The cl inicians i n the$6scoring model $559 subject to 97.5% 97.5% $2gibili ty model$5 $6 number of-$1 exceeded theSurgery upper bound estimate of M IPS eli gible cli nicians due to discrepancies between scoring model data on QPs and QP eli gibili ty model 8,956 $1,924 95.1% 95.1% 4.9% $5 $11 $16 -$4 $12 estimates. Urology ** * * Specialty as self -reported in the$871 National Plan94.5% and Provider 94.5% Enumeration 5.5% System (NPPES). categories are$7mutuall y exclusive, including 3,080 $2 N ote that all $5 -$2 $6 General Vascular descriptions Surgery Practice and Famil y Practice. Famil y M edicine physicians self -report as being i n ‘Family Practice’ in NPPES. 3 0.4% 0.9% 1.0% 0.6% 0.6% Notice: This HH S-approved document has been submitted to the Office of the Federal Register (OFR) for publi cation and has not yet been placed on publi c display or publi shed i n the Federal Register. This document may vary sli ghtly f rom the of f i cial publi shed document if minor editorial changes have been made during the OFR review process. The document publi shed i n the Federal Register i s the of f i cial HH S-approved document. I f you need to access the i nformation i n this document with assistiv e technology, please email W esley.W ei@cms.hhs.gov. TABLE 61: MIPS ESTIMATED PAYMENT YEAR 2019 IMPACT ON TOTAL ALLOWED CHARGES BY SPECIALTY, Number of Allowed Percent PARTICIPATION Percent Percent ASSUMPTIONS Aggregat Aggregat Aggregat Aggregate Net Impact of MIPS ALTERNATIVE * Clinician Specialty/Type MIPS Eligible Clinicians Charges (mil) TIN/NPIs Eligible Eligible Eligible Clinicians Clinicians Clinicians (TIN/NPIs) (TIN/NPIs) (TIN/NPIs) engaging with with Positive with quality or Negativ data Neutral e submission ** MIPS Payment e Positive e Positive e Impact Impact MIPS MIPS Positive Negativ Payment Payment MIPS e MIPS Adjustment, Adjust-ment, Exceptional Excluding Payment Payment Performance Exceptional Adjustme Adjustment P a y m e n t Only Performance Payment (mil) (mil) (mil)* nt MIPS Payment Adjustments (mil)** Net Impact of MIPS Payment Adjustments as Percent of Allowed Changes** mil Payment ) Adjustmen Adjustmen t t ALL MIPS ELIGIBLE CLINICANS SUBJECT 592,119- $76,598- TO DATA SUBMISSION 642,119 $81,380 REQUIREMENTS*** ALL SPECIALTIES 676,722 $78,454 91.9% 91.9% 8.1% $321 $500 $821 -$321 0.6% 676,722 2,389 $251 85.1% 85.1% 14.9% $1 $1 $2 -$2 0.2% 2,389 Anesthesiology 29,845 $1,982 94.2% 94.2% 5.8% $6 $8 $13 -$8 0.3% 29,845 Cardiology 24,657 $5,172 92.6% 92.6% 7.4% $24 $40 $65 -$17 0.9% 24,657 Chiropractic 4,485 $247 75.1% 75.1% 24.9% $1 $1 $1 -$3 -0.6% 4,485 1,267 $46 88.0% 88.0% 12.0% $0 $0 $0 $0 -0.1% 1,267 1,170 $125 92.3% 92.3% 7.7% $1 $1 $1 $0 0.8% 1,170 2,560 $257 91.3% 91.3% 8.7% $1 $2 $3 -$1 0.5% 2,560 447 $16 89.7% 89.7% 10.3% $0 $0 $0 $0 0.0% 447 10,328 $2,960 85.7% 85.7% 14.3% $12 $16 $28 -$15 0.4% 10,328 41,687 $2,722 96.7% 96.7% 3.3% $8 $9 $16 -$4 0.5% 41,687 (SCORING MODEL) Allergy/Immunology Clinical Nurse Specialists Colon/Rectal Surgery Critical Care Dentist Dermatology Emergency Medicine 4 5,065 $474 93.9% 93.9% 6.1% $2 $4 $6 -$2 0.9% 5,065 71,073 $5,802 92.1% 92.1% 7.9% $26 $46 $72 -$26 0.8% 71,073 Gastroenterology 12,168 $1,595 92.6% 92.6% 7.4% $7 $12 $19 -$5 0.8% 12,168 General Practice 2,389 $228 81.9% 81.9% 18.1% $1 $1 $2 -$2 -0.2% 2,389 General Surgery 18,118 $1,734 91.4% 91.4% 8.6% $7 $12 $19 -$8 0.7% 18,118 Endocrinology Family Medicine **** Notice: This HH S-approved document has been submitted to the Office of the Federal Register (OFR) for publi cation and has not yet been placed on publi c display or publi shed i n the Federal Register. This document may vary sli ghtly f rom the of f i cial publi shed document if minor editorial changes have been made during the OFR review process. The document publi shed i n the Federal Register i s the of f i cial HH S-approved document. I f you need to access the i nformation i n this document with assistiv e technology, please email W esley.W ei@cms.hhs.gov. Clinician Specialty/Type Number of Allowed MIPS Eligible Clinicians Charges (mil) TIN/NPIs Percent Percent Percent Aggregat Aggregat Aggregat Aggregate Eligible Eligible Eligible e Positive e Positive e Impact Impact Clinicians Clinicians Clinicians (TIN/NPIs) (TIN/NPIs) (TIN/NPIs) engaging with with Positive with quality or Negativ data Neutral submission MIPS ** Payment e MIPS MIPS Positive Negativ Payment Payment MIPS e MIPS Adjustment, Adjust-ment, Excluding Exceptional Payment Payment Exceptional Performance Performance Payment Only Adjustme Adjustment Payment (mil) (mil) (mil)* nt MIPS Net Impact of MIPS Net Impact of MIPS Payment Adjustments (mil)** Payment Adjustments as Percent of Allowed Changes** mil Payment ) Adjustmen Adjustmen t t Hand Surgery 1,769 $253 86.7% 86.7% 13.3% $1 $1 $2 -$1 0.3% Infectious Disease 5,412 $684 89.8% 89.8% 10.2% $3 $4 $7 -$5 0.3% 5,412 Internal Medicine 80,871 $9,320 91.6% 91.6% 8.4% $41 $70 $111 -$39 0.8% 80,871 1,886 $389 95.6% 95.6% 4.4% $1 $2 $3 -$1 0.5% 1,886 Nephrology 7,048 $1,598 91.1% 91.1% 8.9% $7 $11 $17 -$6 0.7% 7,048 Neurology 12,540 $1,405 90.7% 90.7% 9.3% $6 $9 $14 -$9 0.4% 12,540 4,470 Intervention al Radiology 1,769 Neurosurgery 4,470 $696 90.1% 90.1% 9.9% $3 $4 $7 -$4 0.4% Nuclear Medicine 540 $98 92.4% 92.4% 7.6% $0 $1 $1 -$1 0.3% 540 Nurse Anesthetist 23,892 $700 95.1% 95.1% 4.9% $2 $3 $4 -$3 0.2% 23,892 Nurse Practitioner 51,004 $1,763 93.6% 93.6% 6.4% $7 $12 $19 -$11 0.4% 51,004 Obstetrics/Gynecology 18,578 $487 95.6% 95.6% 4.4% $2 $3 $5 -$2 0.6% 18,578 Oncology/Hematology 10,368 $4,747 93.9% 93.9% 6.1% $19 $29 $48 -$14 0.7% 10,368 Ophthalmology 16,502 $7,689 93.6% 93.6% 6.4% $39 $68 $108 -$9 1.3% 16,502 Optometry 12,116 $926 87.5% 87.5% 12.5% $3 $5 $8 -$4 0.4% 12,116 129 $5 93.0% 93.0% 7.0% $0 $0 $0 $0 0.6% 129 Orthopedic Surgery 19,360 $3,286 88.1% 88.1% 11.9% $13 $18 $30 -$17 0.4% 19,360 Other MD/DO 10,764 $1,281 90.7% 90.7% 9.3% $5 $7 $12 -$7 0.4% 10,764 Otolaryngology 7,812 $969 88.9% 88.9% 11.1% $4 $5 $9 -$5 0.4% 7,812 Pathology 10,433 $1,020 94.2% 94.2% 5.8% $3 $4 $7 -$5 0.2% 10,433 4,565 Oral/Maxillofacial Surgery 5 Pediatrics 4,565 $59 98.6% 98.6% 1.4% $0 $0 $1 $0 0.9% Physical Medicine 6,357 $997 85.3% 85.3% 14.7% $3 $5 $8 -$7 0.1% 6,357 Physician Assistant 42,402 $1,284 94.8% 94.8% 5.2% $5 $8 $13 -$6 0.5% 42,402 Plastic Surgery 2,449 $243 88.5% 88.5% 11.5% $1 $1 $2 -$2 0.3% 2,449 Podiatry 13,598 $1,800 77.7% 77.7% 22.3% $5 $7 $13 -$16 -0.2% 13,598 Psychiatry 14,044 $864 79.9% 79.9% 20.1% $3 $4 $7 -$12 -0.6% 14,044 Notice: This HH S-approved document has been submitted to the Office of the Federal Register (OFR) for publi cation and has not yet been placed on publi c display or publi shed i n the Federal Register. This document may vary sli ghtly f rom the of f i cial publi shed document if minor editorial changes have been made during the OFR review process. The document publi shed i n the Federal Register i s the of f i cial HH S-approved document. I f you need to access the i nformation i n this document with assistiv e technology, please email W esley.W ei@cms.hhs.gov. Clinician Specialty/Type Number of Allowed MIPS Eligible Clinicians Charges (mil) TIN/NPIs Percent Percent Percent Aggregat Aggregat Aggregat Aggregate Eligible Eligible Eligible e Positive e Positive e Impact Impact Clinicians Clinicians Clinicians (TIN/NPIs) (TIN/NPIs) (TIN/NPIs) engaging with with Positive with quality or Negativ data Neutral submission MIPS ** Payment e MIPS MIPS Positive Negativ Payment Payment MIPS e MIPS Adjustment, Adjust-ment, Excluding Exceptional Payment Payment Exceptional Performance Performance Payment Only Adjustme Adjustment Payment (mil) (mil) (mil)* nt MIPS Net Impact of MIPS Net Impact of MIPS Payment Adjustments (mil)** Payment Adjustments as Percent of Allowed Changes** mil Payment ) Adjustmen Adjustmen t t Pulmonary Disease 9,910 $1,535 91.4% 91.4% 8.6% $7 $11 $18 -$6 0.7% 9,910 Radiation Oncology 3,364 $1,160 93.5% 93.5% 6.5% $5 $7 $11 -$4 0.6% 3,364 34,613 $4,507 93.8% 93.8% 6.2% $15 $17 $32 -$13 0.4% 34,613 N otes: Radiology StandardRhe scoring model a minimum of 90 percent93.4% of cli nicians 93.4% within each practice size category would participate in quali 3,865 $1,353 6.6% $6 $10 $16 ty data submission. -$4 0.9% 3,865 umatolo gy assumes that *2015 data used to estimate 2017 performance. Payments estimated using 2015 doll ars. Thoracic/Cardiac 95.5%and positive 95.5% 4.5% $3 $5 $8 -$1 1.1% 3,333 * * The Net Impact to Payments i s3,333 the combined $559 impact of negative adjustments and the exceptional performance payment. Surgery ** * T he estimated number of M IPS eli gible cli nicians subject to reporting requirements are based on QP eli gibili ty model estimates. The number of cl inicians i n the scoring model $1,924cli nicians92.2% 92.2% between 7.8% $8 data on QPs $11 $19ty model -$6 0.7% 8,956 Urology exceeded the upper bound estimate8,956 of M IPS eli gible due to discrepancies scoring model and QP eli gibili 3,080 $871 91.8% 91.8% 8.2% $4 $5 $9 -$3 0.6% 3,080 Vascular Surgery estimates. ** * * Specialty descriptions as self -reported in the National Plan and Provider Enumeration System (NPPES) at the time of i ssuance of a National Provider Identif ier (NPI). Note that all categories are mutually exclusive, including General Practice and Family Practice. ‘Famil y M edicine’ is used here for physicians listed as ‘Famil y Practice’ in NPPES. 6 Notice: This HH S-approved document has been submitted to the Office of the Federal Register (OFR) for publi cation and has not yet been placed on publi c display or publi shed i n the Federal Register. This document may vary sli ghtly f rom the of f i cial publi shed document if minor editorial changes have been made during the OFR review process. The document publi shed i n the Federal Register i s the of f i cial HH S-approved document. I f you need to access the i nformation i n this document with assistiv e technology, please email W esley.W ei@cms.hhs.gov. TABLE 62: MIPS ESTIMATED PAYMENT YEAR 2019 IMPACT ON TOTAL ALLOWED CHARGES BYAggregate PRACTICE SIZE,Net Impact of PracticeSize Category Number of Allowed Percent Percent Percent Aggregate Aggregate Positive Aggregat Net Impact of STANDARD PARTICIPATION ASSUMPTIONS MIPS Eligible Eligible Eligible Positive and MIPS e Impact Impact MIPS MIPS Eligible Clinicians Charges (mil) TIN/NPIs Clinicians Clinicians Clinicians Neutral Payment Positiv Negativ Payment (TIN/NPIs) (TIN/NPIs) (TIN/NPIs) MIPS Adjustment, e MIPS e MIPS Adjust- Adjust- engaging with with Positive or with Payment Exceptional Payment Payment ments ments as quality Neutral Negativ Adjustment, Performance Adjustment Adjustment (mil)** Percent of data MIPS e Excluding Payment Only submission** Payment MIPS Exceptional (mil) Adjustment Payment Performance Adjustment Payment (mil) (mil)* Payment Allowed Changes** (mil) ALL MIPS ELIGIBLE CLINICIANS SUBJECT TO DATA SUBMISSION 592,119- $76,598- 642,119 $81,380 N otes: REQUIREMENTS All PRACTICE Practice size i s theSIZES total number of M67IPS eli gible$7 T8IN /NPIs in a94.7% T IN . 6,722 ,454 94.7% 5.3% $199 $500 $699 -$199 $500 0.6% Standard scoring model assumes that a minimum of 90 percent of cli nicians within each practice size category would participate in quali ty data submission. (SCORING MODEL) *2015 data used to estimate 2017 performance. Payments estimated using 2015 doll ars. 147,739 $30,426 90.0% 90.0% 10.0% $72 $173 $244 -$99 $145 0.5% 1-9 clinicians * * The Net Impact to Payments i s the combined impact of negative and positive M IPS payment adjustments and the exceptional performance payment. 63,829 $10,870 90.0% 90.0% 10.0% $24 $55 $80 -$37 $42 0.4% 10-24 clinicians ** * T he estimated number of M IPS eli gible cli nicians subject to reporting requirements are based on QP eli gibili ty model estimates. The number of cl inicians i n the scoring model 132,406 $13,942 92.6% 92.6% 7.4% $31 $70 $101 -$47 $54 0.4% 25 99 clinicians exceeded the upper bound estimate of M IPS eli gible cli nicians due to discrepancies between scoring model data on QPs and QP eli gibili ty model 332,748 $23,216 98.5% 98.5% 1.5% $72 $202 $274 -$16 $258 1.1% 100 or more clinicians estimates. ** * * Specialty descriptions as self -reported in the National Plan and Provider Enumeration System (NPPES) at the time of i ssuance of a National Provider Identif i er (NPI). Note that all categories are mutually exclusive, including General Practice and Family Practice. ‘Famil y M edicine’ is used here for physicians listed as ‘Famil y Practice’ in NPPES 1970 Notice: This HH S-approved document has been submitted to the Office of the Federal Register (OFR) for publi cation and has not yet been placed on publi c display or publi shed i n the Federal Register. This document may vary sli ghtly f rom the of f i cial publi shed document if minor editorial changes have been made during the OFR review process. The document publi shed i n the Federal Register i s the of f i cial HH S-approved document. I f you need to access the i nformation i n this document with assistiv e technology, please email W esley.W ei@cms.hhs.gov. TABLE 63: MIPS ESTIMATED PAYMENT YEAR 2019 IMPACT ON TOTAL ALLOWED CHARGES BY PRACTICE SIZE, Number of AL Allowed TERNATE Perc PARTICIPATION ent Percent ASSUMPTIONS Percent Aggregate Aggregat Aggregat Aggregat Net Impact Net Impact of Practice Size Category MIPS Eligible Charges Clinicians (mil) TIN/NPIs Eligible Eligible Eligible Positive and e Positive e Impact e Impact Clinicians Clinicians Clinicians Neutral MIPS Positive Negative Paymen Payment MIPS t Adjust- Adjust- (TIN/NPIs) (TIN/NPIs) (TIN/NPIs) MIPS Payment engaging with with with Payment Adjustment, quality data Positiv Negativ Adjustment Exceptional submission e MIPS e MIPS , Excluding Performance Payment Payment Exceptional Payment Only Adjustment Adjustment MIPS Payment Payment Adjustment Adjustmen (mil) t (mil)* of MIPS MIPS ments ments as (mil)** Percent of Allowed Changes** (mil) Performanc ePayment (mil) ALL MIPS ELIGIBLE CLINICIANS SUBJECT TO 592,119- $76,598- N otes: 642,119 $81,380 DATA SUBMISSION Practice size i s the total number of M IPS eli gible T IN /NPIs in a T IN . REQUIREMENTS A l ternative scoring model assumes that a minimum of 80 percent of cli nicians within each practice size category would participate in quali ty data submission. *2015 data usedSIZES to estimate 2017 performance. Payments estimated using 2015 doll ars. All PRACTICE 676,722 $78,454 91.9% 91.9% 8.1% $321 $500 $821 -$321 $500 0.6% * * The Net MODEL) Impact to Payments i s the combined impact of negative and positive M IPS payment adjustments and the exceptional performance payment. (SCORING ** * T he estimated number of M IPS eli gible cli nicians subject to reporting requirements are based on QP eli gibili ty model estimates. The number of cl inicians i n the scoring model 147,739 $30,426 80.0% 80.0% 20.0% $109 $161 $270 -$200 $71 0.2% 1-9 clinicians exceeded the upper bound estimate of M IPS eli gible cli nicians due to discrepancies between scoring model data on QPs and QP eli gibili ty model 63,829 $10,870 83.7% 83.7% 16.3% $39 $54 $92 -$59 $34 0.3% 1 0-24 clinicians estimates. 132,406 in the$13,942 92.6% 92.6% 7.4%(NPPES) at the $52time of i ssuance $73 of a National$126 -$47 i er $79 0.6% 2 ians descriptions as self -reported *5*9 * 9* clinic Specialty National Plan and Provider Enumeration System Provider Identif (NPI). Noote that all categories are mutually $23,216 exclusive, including General Practice and ‘Famil $212 y M edicine’ is $333 used here for-$16 physicians listed as ‘Famil 332,748 98.5% 98.5% 1.5%Family Practice. $121 $317 1.4% 1 00 or m re clinicians y Practice’ in NPPES. 1971