American Osteopathic Association

Advancing the distinctive philosophy and practice of osteopathic medicine

How you'll be paid under MACRA

Physicians can choose between two MACRA pathways, both offering the potential to earn bonuses.

Physicians who participate in Medicare Part B will be able to choose between two MACRA pathways: reporting quality data through the Merit-Based Incentive Payment System (MIPS), or participating in an advanced Alternative Payment Model (APM). In 2017, MACRA's first year, all physicians will need to report for MIPS, even if you're participating in an APM. Choosing one pathway doesn't lock you into a decision; you can switch between MIPS and APMs each year if you wish.

MACRA overview for 2017

If you participate in MIPS in 2017, your composite performance score will earn you up to a 4% bonus or a 4% penalty when you receive your payment adjustment in 2019.

If you join an APM in 2017, you'll still need to report for the MIPS. If you treat the minimum number of patients and earn the minimum revenue required to qualify as participating in an APM, you'll receive a 5% bonus in 2019. If not, you'll be subject to MIPS penalties and bonuses for 2017.

MIPS exemptions

If one of these three scenarios applies to you, you won't be subject to the bonuses and penalties of MIPS:

  • It's your first year participating in Medicare Part B.
  • Your Medicare annual billing charges are $30,000 or less and you care for 100 or fewer Medicare patients per year.
  • You're a qualifying participant in an advanced alternative payment model (APM).

 Share This