Don’t worry. It’s not too late!

You still have a chance to participate in the Merit-based Incentive Payment System (MIPS) of the Quality Payment Program and avoid the 4 percent penalty in 2019. This year is a transition year, meaning the reporting is more flexible. You can pick your pace of participation based on your readiness for the program. Not fully prepared? Choose to “test.”

The “test” pace requires you to submit a minimal amount of data before the end of the year. For example, you can submit ONE quality measure for ONE Medicare Part B patient and avoid the penalty. In addition, you can submit via claims through your normal billing process. Let’s choose a quality measure and go through the steps together:

  1. First, select your quality measure by going to Click “MIPS” at the top of the page, and select “Quality Measures.” Scroll down to the “Select Measures” portion. Click the drop-down menu for “Data Submission Method,” and check “Claims.” Out of the 74 measures available, choose one that best fits your practice. For this example, let’s pick “Documentation of Current Medications in the Medical Record,” Quality ID #130.
  2. Next, go to the Quality Payment Program “Resource Library” by clicking “About” at the top of the page. Download the zip file labeled “Quality Measure Specifications.” The documents in this file correspond with the Quality ID numbers of the quality measures. In this example, we would look for 2017_Measure_130_Claims.
  3. Open the document and scroll to the “Quality-Data Coding Options” section to find the necessary QDC code. For Documentation of Current Medications, we would use the code G8427.
  4. You can submit this code on any face-to-face visit with a Medicare Part B patient. Simply enter the code under the primary service you are billing for with a line-item charge of $0.01.
  5. Then, you can check your Remittance Advice (RA) for the code N620 to ensure your claim was received. That’s it. One measure. One patient. No penalty.

If you have further questions or want to prepare for next year, contact us by emailing or calling toll-free Monday through Friday at 1-844-205-5540 from 8:30 a.m. to 5 p.m. CT. Technical assistance is FREE and available immediately.


Julia Alton Tubbs is a recent graduate of Auburn University’s Health Services Administration program and currently works for AQAF, a partner of Qsource, as a Quality Improvement Advisor. Previously, she interned for GlaxoSmithKline’s Vaccines Department in the Czech Republic. Her current focus as a part of the atom Alliance is to work with physicians to ensure regulatory compliance is attained and patient health disparities are reduced.