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Final MIPS 2022 Rule: Important Changes

by Team Techvilly

For the 2022 performance year, the Quality Payment Program (QPP) final rule has been made available by the Centers for Medicare and Medicaid Services (CMS). The highlights of the final regulation for 2019 are shown below.

On the QPP MIPS Services website, you may read the complete final rule and fact sheet.

Value Pathways for MIPS (MVPs)

By integrating MIPS measures across the four performance areas particular to a specialty or condition, MIPS Value Pathways (MVPs), a new architecture inside the QPP, aims to produce measure sets more relevant to clinician scope of practice and more meaningful to patient care.

Beginning with voluntary participation, the MVP framework shift will happen in the 2023 performance year. Traditional MIPS will continue to exist until there are enough MVPs to meet demand in order to give time for the development of all of them. The next seven MVPs will be available beginning in 2023:

  1. Development of Rheumatology Coordinating patient care to prevent strokes and foster favourable outcomes
  2. Enhancing Heart Disease Care
  3. Optimizing the Management of Chronic Disease
  4. Promoting Patient Safety and Best Practices in Emergency Medicine
  5. Enhancing Lower Extremity Joint Repair Care
  6. Support for Anesthesia Positive Experiences

MIPS Qualification
In 2022, the list of clinician types eligible for MIPS will include clinical social workers and certified nurse midwives.

Performance Groups Group Weights
The performance criteria for Quality and Cost will each carry a 30% weighting in 2022. Improvement Activities will continue to carry a 15% weighting and Promoting Interoperability a 25% one.

Performance Limit

The performance threshold (lowest number of points required to avoid a negative payment adjustment) will rise from 60 to 75 points for the 2022 performance year.

It will take 89 points instead of 85 to qualify for a positive payout adjustment under outstanding performance. The higher performance threshold and related additional MIPS payment adjustment factors for exceptional performance will no longer be in effect after the 2022 performance year.

Quality Class

CMS declared its intention to stop accepting measure submissions using the CMS online interface last year. Due to the extension of this deadline, the CMS online interface will still be an available reporting option in 2022.

Pricing Category

Five further episode-based cost metrics will be included in 2022.

Category: Promoting Interoperability

Clinical social workers and small practices will automatically lose weight in the Promoting Interoperability category in 2022 without having to request a hardship exception.

Beginning in 2022, the need for The Immunization Registry Reporting metric will be added to the Promoting Interoperability category’s Public Health and Clinical Data Exchange objective.

Category of Improvement Activities

The Improvement Activities inventory is being updated by CMS, and six metrics are being dropped and seven added. Prior to 2022, SurveyVitals was able to assist in completing the following two improvement activities:

  • Regularly evaluate the patient experience of care using surveys, advisory councils, and/or other mechanisms, according to IA BE 13.
  • Participation in CAHPS or another extra questionnaire, IA PSPA 11


The CAHPS for MIPS survey procedure has been finalized by CMS and will begin in 2022.

In order to improve ICH CAHPS response rates and lessen the patient survey burden, patients questioned for the ICH CAHPS survey will be excluded from CAHPS for MIPS sampling beginning in 2022.

Case Mix Modification

A seventh “Asian language survey” adjuster will be included in CAHPS for MIPS in 2022, in addition to the present six case-mix adjusters.


Due to its poor reliability and response rates, the Access to Specialists metric was previously disqualified from scoring and benchmarking. This metric will once more be scored and benchmarked beginning in 2022.

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