We guide you every step of the way. Navigate by scrolling or using the menu to get up to speed about what it will take to succeed with MIPS in 2023.

Have questions? Give us a call at 1-866-359-4458 9:00 AM to 5:00 PM ET, Monday through Friday to walk through the process with one of our friendly consultants or use the chat tool in the bottom-right hand corner of the website.

Your MIPS Success

Thank you for choosing Mingle Health. This guide will help you understand what to focus on to maximize your MIPS participation. We also have videos and educational opportunities throughout the year to educate you about specific components of the MIPS and QPP.

Make a Plan

MIPS: Succeed in 2023

Did you know? In 2023 you need to earn 75 points to avoid the 9% penalty completely. While not all clinicians and groups will meet the minimum threshold, starting early and earning as many points as possible will help mitigate the potential for a negative adjustment and maximize your success.

While MIPS is indeed getting harder every year, Mingle Health is here to guide you to success.

Meet with your Mingle Consultant to learn all that you need to know, set goals, and create a project plan to participate in all categories of MIPS. Be sure to share important deadlines and milestones with stakeholders in your organization such as clinicians, billing team, and anyone else who assists with quality management efforts.

Mingle Health is dedicated to helping you succeed with MIPS and we are proud to have been recognized as a top performer by KLAS for Quality Management.

2023 MIPS Performance Year

Set a Goal for your MIPS Participation

Take a moment to think about your past performance, systems, and recent submission. Having a realistic goal for your organization’s participation in MIPS and the QPP will help your Mingle Consultant guide you in the program and provide feedback to you. Here are some common goals:

  • Avoid a penalty: protect your Medicare payments from the -9% payment adjustment.
  • Maximize score and positive adjustment: track your score at least quarterly and work to improve your score (and your positive adjustment).
  • Prepare for APM participation & improve year-over-year performance: Alternative payment models typically have quality metrics and financial goals that you must make progress on. Tracking and improving year-over-year performance is important in any payment model.

Working with Your Consultant

What can you expect from your assigned Consultant?

When you work with Mingle Health, you gain access to unmatched MIPS expertise in your assigned Consultant. Your consultant can provide a framework for your MIPS project, offer recommendations, and answer any specific questions you may have.

Your consultant will review your MIPS project progress at regular intervals to facilitate the work you’re doing in the Mingle Health Dashboard and assist when necessary.

What will your consultant expect from you?

To ensure your MIPS project progresses through the year, you’ll need to upload your data to the Mingle Health Dashboard in a regular cadence. You’ll need to set up a MIPS workflow in your organization to make sure you’re not falling behind throughout the year.

You and your team will serve as the champions for your practice improvement. Due to the remote nature of our work, your team should be familiar with attending online meetings and be able to use e-mail, Excel, and our web-based software.

Your team will need to coordinate with internal system vendors such as EHRs and billing systems. Team members will ensure that all necessary files will be provided according to Mingle specifications (see resources below).

Your team will be essential in helping to spark engagement and excitement for your entire clinical and operational staff.

How often will you meet?

Our goal is to be a partner of your practice, helping to navigate challenges and maintain steady progress along the way.

You’ll have access to your Consultant via email, through our website’s chat functionality, or you can give us a call. You can request a meeting with your Consultant when you have specific questions about your MIPS project or if you run into challenges that require your Consultant’s expertise.

MIPS 2023 Project Plan

Our goal is to support your organization in earning the highest MIPS score possible and maximize the ROI for participation. When you work with Mingle, not only do we help you avoid the 9% penalty, we pair you with a knowledgeable and friendly Mingle Health “coach” to guide you every step of the way through the program.

Completing the actions by the dates listed below gives you the best chance of driving your practice quality toward your goals and gives the greatest visibility for monitoring your MIPS score.


Date Action/Milestone
April 15, 2023 Send Q1 Billing Data

Adjust clinicians to be included in quality measure calculations (purchase additional providers, if applicable)

May 1, 2023 Select Measures
May 15, 2023 Send Q1 Numerator Data

Adjust clinicians to be included in quality measure calculations (purchase additional providers, if applicable)

May 30, 2023 Review Initial PI Performance

Select Initial IA Projects

June 15, 2023 Review Initial Quality Measure Performance
July 15, 2023 Send Q2 Billing Data

Adjust clinicians to be included in quality measure calculations (purchase additional providers, if applicable)

August 15, 2023 Send Q2 Numerator Data

Review Quality Measure Performance

October 15, 2023 Send Q3 Billing Data
November 15, 2023 Send Q3 Numerator Data

Review Quality Measure Performance (after numerator data is processed)

January 15, 2024 Send All End-of-Year Data

Enter PI and IA Final Attestations

Finalize clinicians to be included in CMS submission (purchase additional providers, if applicable)

Complete Permission Forms

January 30, 2024 Review Final Performance Scoring
February 9, 2024 Send Validation and Audit Documentation (if selected for audit, as required by CMS)
January 4, 2024 – March 31, 2024 Submit Data to CMS
Q1 2024 Plan 2024 QPP Participation

If you have begun working with us after some of these dates have passed, we will assess together how to best mitigate the risks to your MIPS reporting.

Resources & Further Reading

Here are additional resources to assist you with MIPS and the QPP:

New to MIPS? Have questions?

We’re here to help. Please reach out to your Consultant or use the live chat to ask your questions. You can also call M-F 9am – 5pm ET: 866-359-4458

Establish a Quality Reporting Rhythm

Uploading Data to Mingle Health

Upload your billing and performance data as soon as possible so you know your data process is working and you understand your current scores. Plan to send data and review your scores at least quarterly.

Take a moment to plan out how you will send data on a regular basis to Mingle Health for analysis. You’ll also want to think about how you share your measure performance with your team.

How to Log In

How to Enter Improvement Activities

How to Complete the PI Pre-Assessment

How to Finalize the Quality Category

How to Finalize Your Submission

Review Past Performance

Analyzing your past performance is one of the best ways to understand how you are scoring under MIPS.

Take a moment to pull together prior reports and data to understand what worked well and areas for improvement including data capture, workflows, and EHR vendor requirements.

Make sure to download your most recent CMS Feedback Report which includes a breakdown of your past MIPS scores, including the MIPS Cost category. CMS typically publishes Feedback Reports for the prior performance year in July.

Questions to ask:

  • How did you score in each category?
  • Are those scores aligned with your goals?
  • What are your areas of strength? What could be improved this year?

Make sure to share your questions, responses, and prior year performance reports with your Mingle Consultant.

Make sure your have access to the CMS QPP Portal

You’ll need a CMS HARP account to access the QPP Portal. This is where you’ll view and download your prior year CMS Feedback Report and more.

Here’s the CMS resource on how to register for an account

2023 Changes & 75 Points to Avoid Penalty

MIPS continues to increase in difficulty every year.

Importantly, the threshold to avoid a penalty will stay at 75 points for 2023. This means that it’s still tough to avoid the 9% penalty under MIPS.

Because MIPS is getting harder, we advise our clients to monitor their MIPS performance throughout the year. This means estimating your scores at least quarterly so you have the opportunity to spot gaps and areas for improvement and make changes before the end of the year.

Scoring as high as possible will help you mitigate the potential for a negative payment adjustment. You’ll receive the maximum 9% penalty if you fail to participate but were MIPS eligible and didn’t receive an exclusion.

Here’s a summary of changes for the program this year:


  • Quality continues to be worth 30% of your total 2023 MIPS score
  • Data completeness remains at 70% for Quality
  • CMS has changed seventy-six Quality measures in the 2023 Final Rule. There have also been nine Quality measures added and eleven measures removed.
  • The 3-point floor for scoring measures (with some exceptions for small practices) will be removed beginning in performance year 2023


We’ve created a 15-minute video lesson to help you understand the basics of the Cost Category. You can access the lesson in our resource center, or by clicking this link: Understanding the Cost Category

  • Cost is worth 30% of your total 2023 MIPS score
  • CMS calculates Cost measures automatically through Administrative Claims
  • For 2023, CMS has introduced a 1% improvement score available for MIPS participants who have improved their scoring in the Cost Category from one Performance Year to the next.

Promoting Interoperability

  • Promoting Interoperability remains at 25% of your total 2023 MIPS score
  • Nurse Practitioners, Physician Assistants, Certified Registered Nurse Anesthetists, and Certified Nurse Specialists will no longer qualify for Automatic Reweighting in the Promoting Interoperability category.

Improvement Activities

  • Improvement Activities remain at 15% of your total 2023 MIPS score
  • In the 2023 Final Rule, there were four Improvement Activities added, five activities modified, and six activities removed.
  • To earn full credit for IA, you generally need to submit one of the following combinations of activities:
    • Two high-weighted activities
    • One high-weighted activity and two medium-weighted activities
    • Or four medium-weighted activities

Mingle Health | MIPS Changes in 2023: Your Success Guide Download Now

Click here to download our 2023 MIPS Changes Guide >>

MIPS Eligibility

There are no changes to previously eligible clinicians: physicians, physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, certified nurse midwives, and social workers. Clinical psychologists and therapists were added in 2019.

You can find more information on how MIPS eligibility is determined on the QPP website >>

For clinicians that fall under the low volume threshold and still want to participate, they can opt in to the MIPS reporting and receive incentive payments based on success within the program.

Clinicians are exempt for any of the following reasons:

  • Qualifying participant in an Advanced APM
  • Low volume threshold:
    • Treat ≤ 200 Medicare patients
    • OR have ≤ $90,000 in Medicare Part B allowable charges
    • OR provide ≤ 200 Medicare Part B services
  • First year provider in Medicare Part B PFS
  • Significant Hardship Exemption OR Extreme or Uncontrollable Circumstances (EUC)

CMS updates eligibility and special statuses at two points in the year called the “MIPS determination Periods:”

  • 1st Determination Period: 10/1/20 – 9/30/22
  • 2nd Determination Period: 10/1/21 – 9/30/23

Visit the CMS NPI Eligibility Look Up Tool here

2024 Proposed Rule Overview

Dr. Mingle’s highlights from the 2024 Proposed Rule can be found in the video below or in our 2024 Proposed Rule blog post here >>

2024 Proposed Rule | Quick Summary

  • CMS has proposed an increase of the MIPS Performance Threshold to 82.
    • That’s an increase of 7 points from the 2023 threshold.
  • CMS has proposed increasing the Promoting Interoperability Performance Period to 180 days (up from 90 days).
    • See our Promoting Interoperability section below for more details on PI in the 2024 Proposed Rule.

Improvement Activities

In the 2024 Proposed Rule, CMS has proposed:

  • Five new activities “to help fill gaps in the inventory.”
  • A modification to one existing activity
    • PSPA_16: Use of decision support & standardized treatment protocols to “explicitly promote the use of clinical decision support (CDS), particularly open-source, freely available, interoperable CDS.”
  • And removing three activities “to help ensure the inventory reflects current clinical practice.”
    • PSPA_29: Consulting Appropriate Use Criteria (AUC) Using Clinical Decision Support when Ordering Advanced Diagnostic Imaging is removed due to disbanding the AUC program.

In addition, CMS has proposed one activity focused on MIPS Value Pathways:

  • IA_MVP, titled “Practice-wide quality improvement in the MIPS Value Pathways Program (MVP).
    • Requires “a clinician to complete a formal model for quality improvement action that is linked to a minimum of three of the measures within the specific MVP.”
      • Formalizes QI activities leading to improvements in quality of care
      • Fosters a culture of participation by staff.
      • Incentivizes voluntary MVP adoption.
    • Clinicians reporting traditional MIPS are ineligible for this activity.
    • Attestation requires that:
      • The chosen MVP is reported. Registration for an MVP is not enough.
      • Completion of the necessary elements of the activity as per the data validation.

CMS has also stated that they “are not revising group reporting requirements for MVP’s at this time.”

  • CMS is applying the group-level requirement to subgroup reporting, which requires 50% of NPI’s billing under the TIN to attest to an activity.
  • “If a subgroup consists of 50 percent or more of the clinicians in the affiliated group, and the subgroup attests to completing an activity, then the group would receive credit for this improvement activity as this meets our standard for a group’s completion of an improvement activity specified at § 414.1360.”

Promoting Interoperability

In the 2024 Proposed Rule, CMS has proposed:

  • An increase in the PI reporting period to 180 days (up from 90 days).
  • A modification to the exclusions for Query of PDMP for providers who don’t electronically prescribe any Schedule II opioids, Schedule III, or Schedule IV drugs during the Performance Period.
  • Requiring a “Yes” attestation on the High Priority Practices SAFER guide measure.
  • And a continuation of PI reweighting for Clinical Social Workers.
    • Note: In 2024 CMS will no longer re-weight PI for physical therapists, occupational therapists, qualified speech-language pathologists, clinical psychologists, and registered dietitians or nutrition professionals (per the 2023 Final Rule.)