(281) 771-DOCS (3627) Registry@USWoundRegistry.com

MIPS - The Basics

How Medicare Rewards or Penalizes Physicians for Quality Care Documentation SIGN UP TODAY

The federal government knows that financial incentives are the most effective way to implement change in an industry.

At the start of 2017, The Centers for Medicaid and Medicare Services (CMS a.k.a. Medicare) announced a new Quality Payment Program called MIPS (Merit-based Incentive Program). MIPS is like the great-great-grandchild of Meaningful Use, another program that financially incentivized physician practices and hospitals to make changes the federal government wants. After Meaningful Use and Meaningful Use 2 came PQRI, and then PQRS, and now MIPS.

In 2017, CMS laid out MIPS like this: complete a few tasks (or “measures”) that prove you’re improving the quality of your care and we won’t cut your Medicare reimbursements, but complete several measures along those lines and we will increase your Medicare reimbursements. Those various measures each have a weighted score attached to them, like in a football game. Some MIPS measures are worth 7 points, some worth 1, and so on. For the first year of MIPS (2017), you had to score at least 3 points to avoid having 4% of your Medicare reimbursements cut in 2019. For the reporting year of 2018 you had to score 15 points to avoid losing 5% of your Medicare reimbursements in 2020. For 2019, you had to score a minimum of 30 points to avoid losing 7% of your Medicare reimbursements in 2021.

For MIPS Reporting Year 2020, you need to score a minimum of 45 points to avoid losing 9% of your Medicare reimbursements.

Needless to say, this game CMS created is getting more difficult and more important. To add to that stress, CMS is building a website wherein all clinicians’ MIPS scores are published and available to the public. If you don’t score well in MIPS, the whole world will see your shortcomings and think you provide sub-par care based on the data you reported to CMS. Additionally, private payors are beginning to use MIPS scores to determine their reimbursement rates and physician fee schedules.



Quality Scores

By completing Quality measures, you can score up to 45 points for MIPS 2020.

Promoting Inter-operability

You can score up to 25 points by completing Promoting Interoperability measures for 2020.


Improvement Activities

You can score up to 15 points by completing Improvement Activities (also called CPIAs or IAs) for 2020. These are small projects your practice can complete quickly. But in 2020, you have to do more to avoid a 9% penalty!


You can score up to 15 points for Cost in 2020. However, this category is calculated by CMS and their is almost nothing a medical provider can do to influence their Cost scores. 

Is MIPS worth my time?

Is 35 minutes worth saving 9% of your Medicare reimbursements? If so, sign up now.

The US Wound and Podiatry Registries makes MIPS reporting super easy. We’ll help you beat MIPS and avoid the 9% penalty as fast as possible. Most customers meet the minimum MIPS requirements in about 35 minutes. 

MIPS IS Harder Than Ever In 2020!


Penalty is bigger

The penalty for not meeting the minimum requirements of MIPS in 2020 increases to a 9% cut of your Medicare reimbursements.

Passing Score is Higher

The minimum required score to avoid the 2020 MIPS penalty increases to 45 MIPS points! It was only 30 points for MIPS 2019 and 15 for MIPS 2018.


It takes More Work

You can no longer beat MIPS by only completing Improvement Activities. You must now also complete another MIPS component -- like Quality measures or Promoting Interoperability measures -- in order to meet the 2020 MIPS minimum requirements and avoid a 9% reduction in Medicare reimbursements.

Must Use an Updated EHR

CMS is requiring all medical providers to use a 2015 Certified EHR (the latest updated standards) in 2020 in order to meet the minimum MIPS requirements and avoid a 9% cut to their Medicare reimbursements. Click here to see if the EHR version you are using is 2015 certified.