The Centers for Medicare & Medicaid Services (CMS) has announced that the Medicare Quality Payment Program (QPP) Merit-Based Incentive Payment System (MIPS) Cost Performance Category will be reweighted for the 2020 reporting period to 0% of the final score, even if eligible physicians or groups submitted 2020 data in other MIPS categories in light of the impact of the COVID-19 pandemic.

The American Medical Association (AMA), California Medical Association (CMA) and others have been recommending that CMS zero out this category during the pandemic, for concerns that a decrease in patient visits and increase in the costs of caring for patients with COVID-19 could unfairly penalize physicians.

Additionally, CMS has announced that it would release the 2018 and 2019 cost measure benchmark files in an effort to increase transparency in how the agency evaluates physician performance in the Cost Performance Category in MIPS and to allow physicians and other stakeholders to assess the measures for validity and opportunities to reduce spending. 

Stakeholders can now review files and identify target spending for those years, determine how the benchmarks capture any variations in spending, and whether the benchmarks are leading to fair and valid comparisons among physicians.

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