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.
Performance Year
Select your performance year.
2024 MIPS Determination Period and Snapshots
MIPS Determination Period
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 | Release on QPP Website |
---|---|
Segment 1 | Initial Eligibility |
Segment 2 | Final Eligibility* |
*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
Clinicians New to a Practice during Segment 2
If you start billing Medicare Part B claims under a practice’s
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
- 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