With the 2024 performance year of the Merit-Based Incentive Payment System (MIPS) currently underway, we wanted to provide tips and dispel common misconceptions to ensure your practice is successful in the program and avoids any payment penalties in 2026.

MIPS-Conception 1: Submitting any MIPS data in 2024 is enough to avoid payment penalties in 2026.

To avoid penalties on Medicare Part B reimbursements in 2026, you must score at least 75 points (out of 100) on your final MIPS 2024 score. Although this threshold has remained unchanged since 2022, it's crucial to review the latest 2024 quality measures and other MIPS requirements, as these can vary each year.

What you can do now:

• Review the list 2024 MIPS Quality Measures Relevant to Ophthalmology. Ensure you are familiar with your options for quality measures and the points available for each measure.
• Review EyeNet’s MIPS 2024 Resources. The Academy has developed ophthalmic-specific guides and other resources to keep you up to date on the latest MIPS changes and requirements.

MIPS-Conception 2: I was approved for an exception for MIPS 2023, and I don’t need to do anything to receive an exception for 2024.

False. The Centers for Medicare & Medicaid Services (CMS) is allowing eligible clinicians to apply for exception applications in 2024 until Dec. 31, 2024. However, you must reapply for exceptions each year, even if you were approved for a previous year. Note that submitting data for any performance category will override your exception application.

There are a few changes in 2024 regarding exception applications:

• The COVID-19 public health emergency ended May 11, 2023. As a result, CMS will no longer accept MIPS exception applications due to COVID-19 for the 2024 performance year.
• Practices affected by the Change Healthcare cyberattack can request an extreme and uncontrollable circumstances (EUC) exception. When applying, select “ransom/malware” as the Event Type and indicate it pertains to the Change Healthcare cyberattack.
• CMS will continue to provide automatic reweighting in some cases. Practices with special status, such as those with 15 or fewer eligible clinicians, will have the promoting interoperability performance category automatically reweighted to 0%. Clinicians in regions affected by extreme and uncontrollable events (e.g., FEMA-designated major disasters) during the 2024 performance year will receive an automatic extreme and uncontrollable circumstances exception.

Staying informed is key to participating successfully in the MIPS program and avoiding penalties in 2026. The Academy is here to help with any MIPS-specific questions. Please reach out to us at mips@aao.org if you have any questions.