Dermatologists must navigate the complexities of the Merit-based Incentive Payment System (MIPS) in 2024. Whether you are managing chronic skin conditions, performing procedures, or running a busy practice, understanding MIPS is essential to avoid penalties and potentially gain incentive payments. This blog will break down key MIPS details for dermatologists and provide actionable tips for optimizing your performance.
Why MIPS Matters for Dermatologists
MIPS participation is critical for dermatologists who meet the low-volume threshold and bill Medicare Part B. Failing to report to MIPS can result in penalties that affect your Medicare payments. On the other hand, successful participation can earn you bonuses. As a dermatologist, ensuring your practice meets these standards is vital for maintaining financial health and compliance.
Understanding the Key MIPS Categories for Dermatologists in 2024
MIPS is broken down into four main categories:
Quality (30% of your score)
The Quality category is essential for dermatologists, as it reflects your clinical performance in treating skin-related conditions. Relevant measures include:
Measure #137: Melanoma: Continuity of Care – Recall System: Tracks how effectively you manage follow-up care for melanoma patients.
Measure #138: Melanoma: Coordination of Care: Focuses on ensuring melanoma patients receive coordinated care across multiple providers.
These measures align well with the type of care dermatologists provide regularly. Reporting on these quality measures can enhance both your clinical outcomes and your MIPS score.
Cost (30% of your score)
Dermatologists should keep an eye on cost-related treatments, especially for chronic skin conditions or complex procedures. CMS calculates the Cost score based on claims data, so there is no direct reporting required. However, managing costly treatments like biologics for conditions such as psoriasis or chronic eczema will be crucial to maintaining a favorable Cost score.
Promoting Interoperability (25% of your score)
This category focuses on how well you use certified electronic health record (EHR) systems. Dermatologists can excel in this category by:
E-prescribing for dermatologic medications, including biologics, steroids, and antibiotics.
Providing patients access to their medical records through secure patient portals.
If your dermatology practice faces challenges with EHR adoption, you may qualify for an exemption, reweighting this category to zero.
Improvement Activities (15% of your score)
Many dermatologists already engage in activities that enhance patient care, making this category relatively easy to fulfill. Common Improvement Activities relevant to dermatology include:
Offering telehealth consultations for skin conditions that don’t require in-person visits, such as acne or follow-up care for chronic conditions.
Patient education on skin cancer prevention, especially in high-risk populations.
Same-day or next-day access for urgent conditions such as severe rashes, infections, or concerning lesions.
Practical Steps for Dermatologists to Succeed in MIPS
Select Dermatology-Specific Quality Measures: Focus on measures related to skin cancer management, chronic skin conditions, and preventive care. These are highly relevant to your patient base and will be easy to track.
Leverage Telehealth and Patient Education: If you already offer virtual consultations or provide educational resources to your patients, ensure you document these efforts for the Improvement Activities category.
Monitor Costs of Treatments: Dermatologic treatments, especially for chronic conditions, can be costly. Work with patients and payers to manage the costs of biologic treatments, laser therapies, and other expensive interventions.
Ensure EHR Compliance: If your practice uses an EHR system, focus on achieving compliance with e-prescribing and patient portals. If your practice struggles with EHR adoption, consider applying for a Promoting Interoperability hardship exemption.
Special Considerations for Dermatologists
Small Practice Status: If your practice has fewer than 15 providers, you qualify for small practice status. This gives you additional flexibility, such as extra points in the Quality category and potential exemptions from Promoting Interoperability.
Exclusions: If your Medicare billing doesn’t meet the low-volume threshold (currently less than $90,000 in allowed charges or fewer than 200 Medicare patients), you can apply for a MIPS exclusion. Be sure to check your eligibility via CMS’s participation lookup tool.
Don’t Let MIPS Penalize Your Dermatology Practice
Navigating MIPS doesn’t have to be overwhelming for dermatologists. By selecting relevant quality measures, managing costs, utilizing telehealth, and ensuring compliance with your EHR, you can successfully navigate the program and avoid penalties. Prepare now to maximize your MIPS score and secure higher reimbursements in 2024. Contact Us today to see if we can help! 803-205-2544
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