Podiatrist are required to navigate the complexities of the Merit-based Incentive Payment System (MIPS) in 2024 if they meet eligibility criteria. Understanding how MIPS impacts your practice’s Medicare reimbursements is essential to avoid penalties and potentially gain incentive payments. In this blog, we’ll outline key MIPS details specific to podiatry and provide actionable tips to optimize your performance.
Why MIPS Matters for Podiatrists
MIPS participation is crucial for podiatrists who bill Medicare Part B and meet the low-volume threshold. Failure to report can result in a penalty of up to 9% of your Medicare payments in 2026 (based on 2024 performance). By successfully participating, you can avoid these penalties and possibly receive positive payment adjustments based on your final MIPS score.
Understanding the Key MIPS Categories for Podiatrists in 2024
MIPS is divided into four main performance categories:
Quality (30% of your score)
The Quality category assesses clinical performance. For podiatrists, many measures directly relate to common conditions like diabetic foot ulcers, peripheral arterial disease, and preventive foot care for high-risk patients. Relevant measures include:
Measure #126: Diabetic Foot Care and Patient Education – Tracks patient education and care for diabetic patients to help prevent complications like ulcers and infections.
Measure #127: Diabetic Foot Care and Ulcer Prevention – Assesses how often you perform regular ulcer risk assessments for diabetic patients.
These measures align closely with the care you provide regularly, making them valuable for reporting. By documenting your performance in managing these conditions, you’re likely to meet your Quality reporting requirements with ease.
Cost (30% of your score)
For the Cost category, CMS uses claims data to evaluate how efficiently you deliver care. Podiatrists should be aware that higher-cost treatments, like foot surgeries or chronic care management, may affect your score. You don’t need to submit data for this category, but managing the cost of care, particularly in conditions like diabetic foot complications or chronic wounds, is crucial to maintaining a favorable Cost score.
Promoting Interoperability (PI) (25% of your score)
The PI category measures how well you use certified electronic health record technology (CEHRT). If your podiatry practice uses EHR systems, focus on areas like:
E-prescribing: Ensure you’re using electronic prescribing for all applicable medications.
Patient access to their health information: Patients should have access to their records through a secure portal.
If you’re in a small practice or face significant challenges in adopting technology, you may qualify for a hardship exemption, which can reweight the Promoting Interoperability category to zero.
Improvement Activities (15% of your score)
Improvement Activities involve initiatives that enhance patient care. Common podiatry-specific Improvement Activities include:
Patient Education on Foot Care: Engaging diabetic patients in educational programs that help them prevent foot ulcers or infections can qualify as an Improvement Activity.
Telehealth Services: Many podiatry patients, particularly those with mobility issues, can benefit from telehealth visits. This has become even more relevant in recent years and can count as an Improvement Activity.
Same-day or Next-day Access: Offering urgent care appointments for patients with acute foot pain or infection can also be counted as an activity.
Practical Steps for Podiatrists to Succeed in MIPS
Choose the Right Quality Measures: Focus on quality measures that align with common podiatric conditions like diabetic foot care, ulcer prevention, and peripheral arterial disease management. These are relevant to your patient base and easy to track with proper documentation.
Leverage Existing Tools for Improvement Activities: Most practices already perform activities like patient education and urgent care appointments. Ensure these are documented properly and submitted as Improvement Activities for MIPS. Consider using telehealth, particularly for patients with chronic conditions or limited mobility, to fulfill this category.
Track Your Cost Data: Since CMS uses claims data to calculate your Cost score, ensure you’re managing the cost of treatments like diabetic foot care and chronic wound management effectively. Keeping a close eye on which procedures or treatments drive up costs can help you make adjustments to maintain a good score.
Ensure EHR Compliance: If your practice uses an EHR, make sure it’s certified for MIPS participation. Focus on e-prescribing and patient portal access, and ensure your staff is trained to use the system efficiently. If your practice struggles with adopting EHR systems, explore whether you qualify for a Promoting Interoperability hardship exemption.
Special Considerations for Podiatrists
Small Practice Status: If your practice has 15 or fewer providers, you qualify for small practice status. This gives you additional flexibility, including receiving extra points in the Quality category and potentially being exempt from Promoting Interoperability reporting.
Exclusions: If you don’t meet the low-volume threshold (less than $90,000 in Medicare charges or fewer than 200 Medicare patients), you can apply for an exclusion from MIPS reporting. Be sure to check your eligibility annually via CMS’s participation lookup tool.
Don’t Let MIPS Penalize Your Podiatry Practice
MIPS may seem complex, but with proper planning, podiatrists can avoid penalties and even earn bonuses. By selecting podiatry-specific quality measures, managing costs, utilizing telehealth, and ensuring compliance with your EHR, your practice can successfully navigate MIPS in 2024.
Make sure to review your participation status and start preparing now to optimize your MIPS score and secure higher reimbursements. By staying ahead of the requirements, your podiatry practice can thrive under the MIPS program. Contact us today to see if we can help! 803-205-2544
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