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2018 Promoting Interoperability hardship applications are available and must be submitted by December 31, 2018.

2017 feedback and information on the 2019 payment adjustment are available. Have questions? Contact us!

Learn about the QOPI Reporting Registry for data submission and see the full 2018 quality measure list!


Reporting Structure

This page is tailored to radiation oncology practices that include more than 15 eligible clinicians. These clinicians or practices do NOT have the “small practice” status associated with their MIPS eligibility, available on the QPP website.


Prior to proceeding, the eligible physicians or group should have already determined that they:

  • Are eligible  for MIPS.
  • Will report as an individual or as a group.
  • Want to participate in MIPS to avoid a negative 5 percent payment adjustment.

To learn more about these questions, view the 2018 MIPS high-level program overview.

It would be nice to hyperlink to the CMS eligibility page when this becomes available for 2018.




The “Quality” Performance Category weight is 50 percent of the Composite Performance Score (CPS). If the physician receives an exemption for the Promoting Interoperability (PI) category or does not qualify for the Cost category, then the Quality category weight is increased to 75 percent and 60 percent, respectively. Radiation oncologists, whether reporting as an individual or a group, can report the Radiation Oncology Measures Set or select six measures from the complete CMS measures list.



Improvement Activities


The “Improvement Activities” (IA) Performance Category allows eligible physicians to attest to completing activities identified as improving clinical practice or care delivery likely to result in improved outcomes. This category weight is 15 percent of the Composite Performance Score (CPS). In this setting, ASTRO envisions that radiation oncologists, whether reporting as an individual or a group, will report on activities satisfied by ASTRO’s two programs: RO-ILS and APEx. If reporting as a group, at least one clinician in the group must perform the activity for the entire group to receive credit. Each improvement activity must be completed for at least 90 consecutive days.



Promoting Interoperability


The "Promoting Interoperability" (PI) performance category, previously known as Advancing Care Information, weight is 25 percent of the Composite Performance Score (CPS). Similar to the previous Meaningful Use program, we anticipate the majority of radiation oncologists will be exempt from this category either because they are classified as a hospital-based physician or qualify for a hardship exemption. If an individual or group are exempt, then this category weight is reduced to 0 percent and redistributed to the Quality performance categories, thereby Quality would be worth 75 percent of CPS.





2018 is the first year where the Costperformance category will affect the final MIPS Composite Performance Score (CPS), worth 10 percent. In 2017, CMS collected cost data using administrative claims and provided feedback to clinicians but it was not incorporated into the 2017 CPS. Providers will not need to report any data for this category. If the two cost measures cannot be calculated for an individual or group, which will likely be the case for most radiation oncologists, then this category weight is reduced to 0 percent and redistributed to the Quality performance category.



As always, each radiation oncology practice and its eligible clinicians are encouraged to review primary materials (statutes, regulations, agency interpretive guidance, etc.) and seek appropriate legal or other professional guidance for a comprehensive understanding of their obligations. The information on this website should not be construed as legal, coding or other professional advice, and ASTRO assumes no liability for the information contained herein.

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