How to Get Started on 2023 MIPS Reporting 

With the newest changes to the MIPS 2023 Final Rule, it’s never too early to begin reporting for PY23. Here are some tips for getting started. 

Determine Eligibility of your Clinicians 

In order to be eligible for MIPS, a clinician must exceed all three of the following thresholds: 

  • Bill more than $90,000 for Medicare Part B covered professional services 
  • See more than 200 Medicare Part B patients during the Performance Year 
  • Provide more than 200 covered professional services to Medicare Part B patients

Pick Your Reporting Strategy 

Individual Reporting – In order to be MIPS eligible as an individual clinician, you must: 

  • Be identified as a MIPS eligible clinician type on Medicare Part B claims 
  • Have enrolled as a Medicare provider before 2023 
  • Not be a Qualifying Alternative Payment Model Participant (QP) 
  • Exceed the low-volume threshold as an individual

If you’re MIPS eligible as an individual, you’re required to report to MIPS.

Group Reporting – In order to be MIPS eligible as part of a group, you must:

  • Be identified as a MIPS eligible clinician type on Medicare Part B claims 
  • Have enrolled as a Medicare provider before 2023 
  • Not be a QP 
  • Be associated with a practice that exceeds the low-volume threshold

While reporting as an individual allows complete control over the performance and payment adjustment, collecting the data individually for your ECs could also mean a large administrative workload. The decision whether to report as an individual or a group depends on the status of your practice and which workflow would be more efficient for your clinicians. To learn more about individual vs. group reporting, see the link here

Choose your Measures and Start Collecting and Reviewing Data

  • Determine what measures are the best to report on: Are all the measures reported on in 2022 still available? 
  • Review reports and identify gaps for areas of improvement 
  • Telehealth Exclusions: Review CMS measure specifications. Some Quality Measures have telehealth exclusions where patients may not be eligible for a measure. 

Don’t Forget about Promoting Interoperability and Improvement Activities 

  • Promoting Interoperability (PI) and Improvement Activities (IA) make up 40% of your final MIPS score 
  • If you are reporting as a group, 50% of your clinicians MUST be participating in your selected Improvement Activities 
  • Promoting Interoperability Exemption: Small Practices are eligible for Automatic Reweighting 

Getting started early on your MIPS reporting is a great way to minimize workload and stay organized throughout the performance year. Register for our free webinar all about reporting here