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    MIPS 2022 Final Rule: Key Updates

    The Centers for Medicare and Medicaid Services (CMS) has released the Quality Payment Program (QPP) final rule for the 2022 performance year. Here are the highlights of the final rule for next year. 

    You can view the full final rule and fact sheet on the QPP website.

    MIPS Value Pathways (MVPs)

    MIPS Value Pathways (MVPs) is a new framework within the QPP intended to create measure sets more relevant to clinician scope of practice and more meaningful to patient care by connecting MIPS measures across the four performance categories specific to specialty or condition.

    The transition to the MVP framework will begin in the 2023 performance year with voluntary participation. To allow time for development of all MVPs, traditional MIPS will remain in place until a sufficient number of MVPs are available. Starting in 2023, the following seven MVPs will be available:

    1. Advancing Rheumatology Patient Care
    2. Coordinating Stroke Care to Promote Prevention and Cultivate Positive Outcomes
    3. Advancing Care for Heart Disease
    4. Optimizing Chronic Disease Management
    5. Adopting Best Practices and Promoting Patient Safety within Emergency Medicine
    6. Improving Care for Lower Extremity Joint Repair
    7. Support of Positive Experiences with Anesthesia

    MIPS Eligibility

    Certified Nurse Midwives and Clinical Social Workers will be added to the list of MIPS-eligible clinician types in 2022.

    Performance Categories

    Category Weights

    In 2022, the Quality and Cost performance categories will each be weighted at 30%. Promoting Interoperability will continue to be weighted at 25%, and Improvement Activities at 15%.

    Performance Threshold

    For the 2022 performance year, the performance threshold (minimum number of points needed to avoid a negative payment adjustment) will increase from 60 to 75 points. 

    The exceptional performance threshold (number of points needed for a positive payment adjustment) will increase from 85 to 89 points. The 2022 performance year will be the last year of the additional performance threshold and the associated additional MIPS payment adjustment factors for exceptional performance. 


    Quality Category

    Last year, CMS announced its intent to end the CMS web interface as a measure collection and submission type. This date has been extended, meaning the CMS web interface will remain a reporting option in 2022.

    CMS is making updates to the quality measure inventory; there will be a total of 200 quality measures available in 2022. See the full list of measures on the QPP website.

    Cost Category

    In 2022, five new episode-based cost measures will be added. 

    Promoting Interoperability Category

    In 2022, the Promoting Interoperability category will be automatically reweighted to 0% for clinical social workers and small practices without the need for a hardship exception application.

    Also starting in 2022, The Immunization Registry Reporting measure will be made a required measure under the Public Health and Clinical Data Exchange objective of the Promoting Interoperability category. 

    Improvement Activities Category

    CMS is updating the Improvement Activities inventory, including the removal of six measures and the addition of seven measures. SurveyVitals was previously able to help satisfy the following two improvement activities that will be removed in 2022:

    • IA_BE_13 “Regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms”
    • IA_PSPA_11 “Participation in CAHPS or other supplemental questionnaire”

    CMS considers these activities to be duplicative of IA_BE_6 “Regularly Assess Patient Experience of Care and Follow Up on Findings,” which is a high-weighted measure supported by SurveyVitals. 

    Typically, new improvement activities must be nominated during the Annual Call for Activities from February 1 to July 1 each year. Starting in 2022, CMS will make an exception that allows for activities to be nominated outside of this established timeframe during public health emergencies.

    CMS has also finalized two new criteria for proposed activities:

    1. They must not duplicate any other activities in the inventory
    2. They should drive improvements that go beyond standard clinical practices

    CAHPS for MIPS

    CMS has finalized changes to the CAHPS for MIPS survey process starting in 2022.


    Starting in 2022, patients surveyed for the ICH CAHPS survey will be excluded from CAHPS for MIPS sampling in order to increase ICH CAHPS response rates and reduce patient survey burden.  

    Case Mix Adjustment

    In addition to the current six case mix adjusters for CAHPS for MIPS, a seventh “Asian language survey” adjuster will be added in 2022.


    The Access to Specialists measure was previously excluded from scoring and benchmarking due to low reliability and response rates. Starting in 2022, this measure will once again be scored and benchmarked.

    MIPS and SurveyVitals

    SurveyVitals can help you satisfy certain MIPS requirements. Learn more on our MIPS page, sign up for a demo, or chat with us using the blue chat icon below.


    November 4th, 2021 Categories: quality category, QCDR, QPP, macra, Performance Year, CMS, MIPS, Quality, quality payment program, reimbursement, regulatory, cost category, promoting interoperability category