The Centers for Medicare & Medicaid Services has released an updated tool to help clinicians determine if they must participate this year in the Merit-based Incentive Payment System, one of two payment pathways for clinicians under the Medicare Access and CHIP Reauthorization Act of 2015. Physicians, physician assistants, nurse practitioners, clinical nurse specialists and certified registered nurse anesthetists should participate in MIPS for 2018 if they annually bill more than $90,000 in Medicare Part B allowed charges and provide care for more than 200 Part B-enrolled Medicare beneficiaries. The tool does not reflect 2017 or 2018 participation in an advanced payment model. CMS anticipates expanding the tool later this spring to include 2018 APM participation status. For more on MACRA and MIPS, visit https://qpp.cms.gov and www.aha.org/MACRA