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Promoting Interoperability and Cost Categories

Promoting Interoperability Category

In the Merit-based Incentive Payment System (MIPS), the Promoting Interoperability category is intended to promote patient engagement and the electronic exchange of information using Certified Electronic Health Record Technology (CEHRT). Clinicians must use CEHRT to qualify for reporting on Promoting Interoperability information.

The Centers for Medicare & Medicaid Services (CMS) will automatically reweight certain clinicians based on their special statuses. Pathologists automatically qualify for reweighting include:

  • Non-patient-facing
  • Hospital-based

Find Out Your Status

The options below will help you check your non-patient facing and hospital-based status:

  • Use the CMS MIPS participation look-up tool and enter your National Provider Identifier (NPI) number to view your QPP participation status by performance year.
    Check QPP participation status
  • If you do not know your NPI number, you can look it up in the NPI registry. 
    Search NPI records

In order to check the non-patient facing and other special statuses of the individual pathologists included in your group:

  1. Log into the CMS Quality Payment Program website
  2. Once logged in, browse to the Tax Identification Number (TIN) affiliated with your group
  3. Access the details screen to view the eligibility status of every clinician based on his or her NPI number

For non-patient facing pathologists and groups, the CMS will automatically reweight the Promoting Interoperability category to 0% and increase the weight of the Quality category to 85%.

Cost Category

Non-patient-facing clinicians, such as pathologists, are not expressly exempted from the Cost category, however, the CMS suggests that many non-patient-facing clinicians may not be able to be attributed to a cost measure. The cost measure attribution is based on whether you are the physician responsible for the outcomes for that patient in that episode of care, and to date, the CMS methodology should not attribute the Cost category to pathologists (and the weight for this category should remain at 0%). If the CMS can attribute you or your practice to a cost measure, the Cost category will be 15% of your MIPS score.

We have a dedicated team to help you succeed in MIPS. Contact us to learn how we can optimize your MIPS performance.

Email: mips@cap.org

Phone: 800-323-4040, option 3