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MIPS Eligibility Determination Period

We update eligibility data at multiple points throughout the year to help you plan your program participation. These updates are based on past and current Medicare Part B claims and PECOS data.

Determination period
 and 
snapshot
 dates may change each
performance year
 due to changing policy.

Performance Year

Select your performance year.

2024 MIPS Determination Period and Snapshots

MIPS Determination Period

Initial Eligibility(Segment 1)Dec. 2023PY 2024 BeginsJan. 1, 2024Final Eligibility(Segment 1 and 2 Reconciled)Dec. 2024PY 2024 EndsDec. 31, 2024

For MIPS, we review past and current Medicare Part B claims and PECOS data for clinicians and practices twice for each performance year. Each review, or “

segment
,” analyzes data from a 12-month period. Analysis of data from segment 1 is released as preliminary eligibility determinations. Analysis of data from segment 2 is reconciled with the results from segment 1 and released as the final eligibility determination.

MIPS Determination Period Segment Details
SegmentRelease on QPP Website

Segment 1
Covers October 1, 2022 – September 30, 2023

Initial Eligibility
December 2023

Segment 2
Covers October 1, 2023 – September 30, 2024

Final Eligibility*
December 2024

*Final eligibility is reconciled between the 2 segments; this determination is final unless you’re identified as a Qualifying APM participant (QP) in Snapshot 3.

We’ll use data from these MIPS Determination Period segment dates to:

  • Determine eligibility (including whether you exceed the 
    low-volume threshold
    );
  • Assign 
    special statuses
    ; and
  • Update clinician lists for each 
    practice
    .

We'll release final (reconciled) eligibility determinations from the 2 segments in December 2024. We'll notify you via the QPP listserv when your new eligibility information is published on the QPP Participation Status Tool. Subscribe to the QPP listserv at the bottom of this page.

If you bill Medicare for Part B services in both segments, you must exceed the low-volume threshold during both segments to be eligible for MIPS.

The following table demonstrates what your final eligibility status determination would be based on the outcome of the low-volume threshold analyses conducted on data from each of the 2 segments:

Segment 1

Segment 2

Final Determination

Below Low-volume Threshold

&

Below Low-volume Threshold

=

MIPS Exempt

Below Low-volume Threshold

&

Above Low-volume Threshold

=

MIPS Exempt

Above Low-volume Threshold

&

Below Low-volume Threshold

=

MIPS Exempt

Above Low-volume Threshold

&

Above Low-volume Threshold

=

MIPS Eligible

Opting-in to Report

If you're identified as exempt from MIPS, you may still be able to 

opt-in
 to report to MIPS for the 2024 performance year if you exceed 1 or 2, but not all 3, elements of the low-volume threshold.

Learn more about opt-in

Clinicians New to a Practice during Segment 2

If you start billing Medicare Part B claims under a practice’s 

Taxpayer Identification Number
 (TIN) during segment 2 of the determination period, your eligibility at that practice will be based solely on the analysis of data from segment 2.

Clinicians New to a Practice after Segment 2

A final review of data takes place in the last 3 months of the year, from the end of segment 2 until the end of the performance year.

If you start billing Medicare Part B claims under a practice’s

 TIN
 during that period, you:

  • Will be considered exempt and receive no 
    payment adjustment
    , or;
  • Will receive the group score and payment adjustment if your TIN reports as a group.

Changing QP Status

Your QP status can change at each APM snapshot depending on whether the APM Entity or individual score meets or exceeds the QP thresholds. If you achieve QP status on any of the 3 QP determination snapshots (Snapshots 1-3), you will maintain that QP status for the performance year unless your APM Entity terminates from the APM prior to the end of the QP performance period.

Learn more about APM Determination Periods

When Can My Eligibility Change?

Your eligibility could change based on a number of factors including joining or leaving a practice. Learn more about how eligibility can change