MIPS Reporting for Medent EMR Users
Patient360 has a longstanding history as a CMS qualified Registry with over 12 years under our belt reporting quality data for our clients.
As a preferred MIPS reporting partner for 
, Patient360 works with clients and your EMR to reduce the burden of MIPS reporting, while helping you achieve your best MIPS score.
What is MIPS Reporting?
You may have heard about the acronym, MIPS, as being a new requirement for your practice, whether you are a part of a larger group, or just a solo therapist. But what is it, really? And do you need to worry about it?
“MIPS” stands for the Merit-based Incentive Payment System and replaces PQRS, Value Based Modifier (VBM) and the Meaningful Use (MU) legacy programs of the past. If eligible, providers must report data to CMS or face a penalty imposed on their billing. In 2020, failure to report if eligible results in a negative 9% adjustment to your practice that will be applied to your 2022 reimbursements.
Am I required to report?
If you meet/exceed ALL of the eligibility thresholds found below, you must report MIPS or you will receive a -9% adjustment.
Certain providers and groups may choose to report as an opt-in or voluntary participant. If your practice would like to dip your toe in the MIPS pool, but are not a required participant, these are options available to you.
Refer to the infographic below to review 2019 thresholds and criteria to identify where your practice falls and what options you have.
2020 MIPS Participation Options
Should I report?
With a 9% penalty applied to eligible providers who do not report, it is in your best interest to, at a minimum, avoid that penalty.
- 45 points meets the minimum to allow your practice to be neutral. IMPORTANT: Being Neutral is still avoiding giving up 9% of your billing!
- 46–84 MIPS points is a small upward adjustment.
- 85+ MIPS points is exceptional performance bonus territory.
The CMS Lookup Tool is active and your practice and providers are able to look up their participation status and what reporting options are available for 2020 by entering your NPI. You can use this tool with certainty, but reach out to us if there are questions on how to interpret your status. We are here to help!
Impact on the Bottom Line
Practice 1
150 Providers
$12,000,000 in Part B Claims in 2020
MIPS Impact = +/- $1,080,000
Practice 2
25 Providers
$2,000,000 in Part B Claims in 2020
MIPS Impact = +/- $180,000
Practice 3
5 Providers
$400,000 in Part B Claims in 2020
MIPS Impact = +/- $36,000
These figures are based on a +/- 9% adjustment. Non-participation in 2020 will automatically result in a -9% adjustment in 2022.
