FAQ Topics
General
Where can find information about Merit-based Incentive Payment System (MIPS)?
Which website do I use to attest?
Quality Payment Program (QPP)
Which edition is NextGen® Office EHR certified for?
2015
What is the NextGen Office EHR certification ID?
0015ELC7MG7SV5Y
What are the four MIPS performance categories?
Quality, Promoting Interoperability, Improvement Activities, and Cost
Where can I get my previous year's scores for reference?
Scores come from the Centers for Medicare & Medicaid Services (CMS). If you need the files that you used to attest, go to My Reports.
Eligibility
How do I check if I'm required or eligible to participate in MIPS?
What support do small practices receive?
Small practices
How do I know if I have been assigned a special status?
Special Statuses
This is my first year with Medicare. Am I required to attest?
No. First-time Medicare providers in the performance year are exempt. You are not required to attest until the subsequent year after enrolling in Medicare.
I am not an eligible clinician. Can I still attest?
Yes. Data can be submitted with a group or individually. However, only ECs are eligible for the payment adjustment.
COVID-19 Response
What flexibilities are allowed for clinicians participating in MIPS because of COVID-19?
MIPS eligible clinicians, groups, and virtual groups can submit an MIPS extreme and uncontrollable circumstances (EUC) exception application to request reweighting any or all MIPS performance categories if you have encountered an extreme and uncontrollable circumstance or public health emergency, such as COVID-19, that is outside of your control.
Where can I find more information about COVID-19 flexibilities?
Quality
Where can I find information about the Quality performance category?
What is a denominator?
All patients who are to be evaluated by the measure. The denominator can the same as the initial patient population or a subset of the initial patient population.
Example: CMS22: All patient visits for patients aged 18 years and older at the beginning of the measurement period.
What is the numerator?
The numerator is a subset of the denominator and refers to the patients who meet the measure's clinical criteria.
Example: CMS22: Patient visits where patients were screened for high blood pressure AND have a recommended follow-up plan documented, as indicated, if the blood pressure is elevated or hypertensive.
Which patient-specific module can you use to manage Quality measures?
Health Measures
What is the Quality Measure Patient List used for?
Tracking the measure population and updating applicable measures.
Why is the patient passing in Health Measures, but failing on the MIPS Dashboard?
The following measures are encounter-based, which means the numerator workflow must be done for every encounter. Each patient appears once per unique encounter with a numerator, failing, or exclusion status even if they have multiple encounters that qualify for each status. Health Measures can only show one result, but when you filter the MIPS Dashboard by denominator you can see encounters for the patient both passing and failing. The performed date reflects the most recent numerator event that occurred during the current reporting period. For more information, refer to the Encounter-Based Measures section of Quality Measure Patient List.
- CMS22: Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
- CMS68: Documentation of Current Medications in the Medical Record
- CMS146: Appropriate Testing for Pharyngitis
- CMS154: Appropriate Treatment with Upper Respiratory Infection (URI)
- CMS161: Adult Major Depressive Disorder (MDD): Suicide Risk Assessment
- CMS177: Child and Adolescent Major Depressive Disorder (MDD): Suicide Risk Assessment
When must the patient have an encounter to be included in the denominator for the Preventive Care and Screening: Influenza Immunization measure?
October 1 of the previous year to March 31 of the current reporting year. For the 2023 performance year, the time period is 10/1/2022–3/31/2023
When does the immunization have to be recorded to count for the Preventive Care and Screening: Influenza Immunization measure?
August 1 of the previous year to March 1 of the current reporting year. For the 2023 performance year, the time period is 8/1/2022–3/31/2023
Why isn't the vaccine counting for the Preventive Care and Screening: Influenza Immunization measure? Which CVX codes count for the measure?
The vaccine may not be applicable for the measure. A list of the influenza vaccine CVX codes are available in the
measure paper.
Promoting Interoperability (PI)
Where can I find information about PI?
For the Provider to Patient Exchange objective, the numerator requires the encounter to be signed within four business days of the encounter. What are considered as business days?
Business days includes weekdays only (Monday–Friday) and excludes weekends. NextGen Office currently does not support excluding holidays as business days.
Example: If the provider sees a patient on Wednesday and the upcoming Monday is a holiday, the provider has until Monday to sign the encounter.
Improvement Activities (IA)
Where can I find more information about IA?
Do I get credit for being a PCMH provider?
Yes. You automatically earn full credit.
Cost
Where can I find information about Cost?
Do I have to submit data for Cost?
No. CMS uses Medicare Part A and B claims data to calculate cost measure performance.
