The exempted physicians include those with less than $30,000 in Medicare charges and fewer than 100 unique Medicare patients per year. Clinicians new to Medicare this year are also exempt this year.
The agency also gave a pass to providers who have implemented a MACRA-compliant Advanced Alternative Payment Model, which is the other value-based reimbursement track doctors complying with the law can choose.
Under MIPS, physician pay will be based on success in four performance categories: quality, resource use, clinical practice improvement and "advancing care information" through use of health information technology.
The advancing care criteria is based on the government's meaningful-use program, which is used to decide whether doctors should be rewarded for using EHRs.
Medicare reimbursement for providers in 2019 will be based on how well doctors perform on these metrics this year. Under MIPS, physicians can earn a bonus or penalty of 4% of their reimbursement in 2019.
The CMS missed a December timeline to notify physicians of MIPS reporting requirements. That delay could have affected some doctors' bottom lines, as they may have spent money to upgrade EHRs and administrative procedures to implement MIPS only to be told they didn't need to, according to Anders Gilberg, senior vice president of government affairs for the Medical Group Management Association.
"With so many exceptions, physicians need to know their status prior to the performance year," Gilberg said. "CMS notifying physicians and group practices in May of the performance year creates confusion and needless frustration."