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MACRA made easy

MACRA made easy

What is MACRA?

Macra stands for medical access and chip reauthorization act and declared ratified on April 26, 2015. It quashes the previously used SGR formula and establishes a new program to pay physicians. Thi program is marked as the latest step in the series of revolutionary steps the centers for medicare and Medicaid Services ( CMS) have taken to promote care quality over volume. At the beginning of 2017, Medicare Part B providers have stepped into an entirely new payment framework called the Quality payment program. ..

MACRA’s new road to Medicare reimbursement

MACRA act 2015 has created a massive number of financial career opportunities for top-notch performance provides with the aid of affiliating financial recompenses to value-based care. Under the aegis of MACRA, CMS steered towards the great Quality Pay Program (QPP). This program has introduced two new avenues to reimbursement: One is the Merit-based Incentive program and the Advanced Alternative Payment model.

What is MIPS?

It an entirely new payment program where you can earn performance-based money in addition to your basic medical payment. This track combines three different existing programs (Meaningful Use, Physician Quality Reporting System, and Value-Based Modifier) with the incorporation of a new component called improvement activities.

Who is Eligible?

People that pay more than 90,000$ per year for offering covered professional services under the Medicare Physician Fee (PFS) and afford covered professional services to the medical beneficiaries in the excess of 200 and furnish more than 200 covered professional services under the FPS.

Who Qualifies as an EP?

Medical professional like Doctors (counting specialists of medication, osteopathy, dental medical procedure, dental medication, podiatric medication, and optometry), Chiropractors, Osteopathic experts, Physician colleagues, Nurse experts, Clinical attendant subject matter experts, Certified enrolled nurture anesthetists, Physical advisors, Occupational advisors, Clinical therapists, Qualified discourse language pathologists, Qualified audiologists, Registered dietitians or nourishment experts.

Who is Exempted?

These people are exempted from this program: Qualifying APM participants Those who provide with the least number of patients of payments Providers marked with 1st enrollment year with medicare part B.

How will MIPS be scored?

Those clinicians, who are eligible and working under MIPS, will be scored annually in four categories based upon performance to derive an aggregate score between 0 and 100. These four evaluation categories are improvement activities, interoperability, cost, and quality. It is upon the discretion of the clinician to participate as an individual or in a group for each and every NPI/TIN combination. Payment adjustments can be applied and the practitioners can be rendered deserving based upon the practice level for group submissions.


Program Year 2021 has already started. Start reporting now to avoid MIPS penalties.

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