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MIPS 2023 Action Plan

Updated: 03/12/2024|Views: 3158

If you are new to MIPS, or have been eligible for years, Tebra is here to help you get started with your efforts to meet MIPS requirements year after year. We’ve created the Quality Payment Program (QPP) 2023 MIPS Action Plan to provide you with the necessary information and steps to get you from running your first report, to submitting your data. Let’s get started:


Check your MIPS participation status by entering your individual NPI at You could be eligible if you answer yes to all three of the following questions:

  1. Do you invoice $90K or more in Medicare Part B allowed charges?
  2. Do you have more than 200 Medicare Part B patients?
  3. Do you provide more than 200 covered professional services to Medicare Part B beneficiaries?

If you answered yes to all of the questions, and you are one of the clinician types listed here, you may be subject to MIPS. Some eligible clinicians could be eligible for an exception. Find out more here.

Take Action

Now that you have confirmed your eligibility for the MIPS 2023 reporting year, it is time start learning the requirements. You can access any of the recorded MIPS training session via Tebra University and you can also use any of the resources listed below.

Our CMS Incentive Program site has a variety of options for you to learn about the various requirements you might be subject to.

Get Ready

Let the following checklist serve as a reminder of the tasks that must be completed to help you be better prepared for the MIPS 2023 reporting year:

Monitor Your Progress

It is important that reports are run and reviewed at least once or twice per month. All items on Your MIPS 2023 Checklist must be completed as early in the year as possible. Some of these items can significantly impact your scores.

  • Complete a Security Risk Analysis or do a reevaluation of your existing security risk analysis.
  • Monitor your reports for the Quality and Promoting Interoperability measures in Clinical (EHR).
  • Modify your workflow as needed to ensure that any given score is improving.
  • Take training on CMS Incentive Programs again if needed.

Attestation Submission Period

Finally, prepare for your attestation and submission of data. The attestation submission period for the 2023 Reporting Year is January 1st to March 31st, 2024. It is crucial that you:

  • Go to Tebra University and find the MACRA /MIPS course. Register for an Attestation Webinar - delivered only during the attestation period (Jan-March).
  • Run your final Quality report for the full 2023 calendar year and download in QRDA format-- unless you reported quality measures via claims.
  • Run your final PI report for the 2023 reporting period of your choice.
  • Gather the supporting documentation for your selected Improvement Activities.
  • Select a registry (unless you are reporting quality measures via claims or QRDA submission).
  • Save your final reports in your MIPS 2023 audit binder and keep the binder for a minimum of 6 years.
  • Create a HARP account to submit your attestation.
  • Submit your MIPS 2023 data to CMS by March 31, 2024.
    Note: The Centers for Medicare & Medicaid Services (CMS) has extended the data submission period for the Merit-based Incentive Payment System (MIPS) eligible clinicians who participated in the 2023 performance year of the Quality Payment Program (QPP). Data can now be submitted and updated until 8 p.m. ET on April 15, 2024.
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