The 2023 Quality Payment Program Proposed Rule is Here - Learn What Changes are Ahead for MIPS Reporting

The Centers for Medicare and Medicaid Services (CMS) released proposed changes to the Quality Payment Program for 2023 on July 7, 2022. A 60-day comment period will be open until September 6, 2022. The proposal could undergo additional changes before the final regulation is issued in November.

2023 Performance Threshold

The proposed rule would continue to use the 75 point performance penalty threshold for the 2023 performance year.

Exceptional Bonus Pool

There will no longer be an additional performance threshold for exceptional performance in 2023. The 2022 performance year is the last year clinicians can earn an exceptional performance bonus.

MIPS Performance Category Weights

CMS is not proposing any changes to the MIPS performance category weights in 2023. For most radiologists, Quality will continue to be weighted at 85% and Improvement Activities will be weighted at 15%.

For small practices, CMS will continue to automatically reweight Improvement Activities performance categories. Quality and Improvement Activities will each be weighted at 50%.

2023 Quality Measure Benchmarks:

The following changes in Quality measure benchmarks go into effect beginning with the 2023 performance period:

• Measures with a benchmark - The 3-point floor is removed for measures that can be scored against a benchmark. These measures will receive 1-10 points.

• Measures without a benchmark - The 3-point floor is removed for measures without a benchmark (except small practices). These measures will receive 0 points (small practices will continue to earn 3 points).

• Measures that don’t meet case minimum requirements (20 cases) - The 3-point floor is removed (except small practices). These measures will earn 0 points (small practices will continue to earn 3 points).

• New measures- New measures are subject to a floor of 7 points in the first year and 5 points in the second year.

MIPS Value Pathways (MVPs)

CMS will make MVPs available for reporting gradually, beginning with the 2023 performance year. However, there will not be any radiology MVPs in 2023.

Click below to read the ACR Preliminary Summary of Radiology Provisions in the 2022 MPFS Proposed Rule