Guide to MIPS Reporting

The Merit-based Incentive Payment System (MIPS) is Medicare’s quality reporting program for eligible clinicians. StrataEMR supports MIPS through claims-based reporting, meaning your quality data submits automatically as part of the claims you already send to Medicare, no separate submission required.

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Check Your Eligibility

Not every Medicare-participating practice is required to report MIPS. CMS requires participation if your practice meets all three of the following thresholds in a calendar year:

• Billed more than $90,000 to Medicare Part B
• Treated more than 200 Medicare beneficiaries
• Provided more than 200 covered professional services to Medicare Part B patients

If your practice does not meet all three thresholds, you may be exempt from MIPS for that reporting year. Confirm your participation status before each reporting year using the CMS Eligibility Lookup tool at qpp.cms.gov. Requirements can change annually, so check even if you were exempt in a prior year.

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How StrataEMR Handles MIPS

StrataEMR uses claims-based reporting - the most common method for outpatient therapy practices. With this approach:

• Quality data submits as Quality Data Codes (QDCs), a type of CPT II code, added directly to your Medicare claims
• StrataEMR evaluates each visit and automatically prompts you to select the correct QDCs during documentation, based on the patient’s age, body area, diagnosis, and CPT codes
• No separate data submission is needed outside your normal billing workflow

There are two important limitations of claims-based reporting to know upfront. First, you can report on up to 5 of the available MIPS measures: reporting all 6 requires a registry-based option, which StrataEMR does not support (see note below). Second, reporting is individual: each clinician’s data submits separately, and group-level reporting is not supported through claims-based submission.

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Activate MIPS for Your Account

MIPS activation is an account-level setting managed by StrataPT, it is not something you configure in StrataEMR directly. Once enabled, MIPS prompts appear for all eligible clinicians at your organization. To activate MIPS reporting, contact your StrataPT Customer Success Manager. They will confirm your eligibility, turn on the MIPS prompts for your account, and load in the appropriate MIPS form templates.

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Complete the MIPS Patient Survey at Initial Evaluation

When you complete an initial evaluation for a Medicare patient, you must also complete a MIPS Patient Survey Form as a separate document. This form captures the screening information required for several MIPS measures, including:

• Depression screening
• Elder maltreatment screening
• Tobacco use

StrataEMR includes both PT and OT versions of the MIPS Patient Survey Form to be created as a clinical document, within the MIPS Templates family. Select the version that matches your discipline. Once you save the Patient Survey Form, your responses carry over automatically to the evaluation document, you do not need to re-enter the same information in the evaluation.

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Record MIPS Codes During Daily Documentation

For each Medicare visit, StrataEMR evaluates the patient’s age, body area, diagnosis year, and CPT codes and identifies which MIPS quality measures apply. When applicable measures are found, a MIPS prompt appears in the charge advice section of the daily note, below the standard billing codes. To complete MIPS reporting for a visit:

1. Complete your clinical documentation as normal.
2. In the charge advice section at the bottom of your document, locate the MIPS prompt below your standard billing codes.
3. Review the measure listed and select the QDC that reflects the care you provided.
4. Complete and submit the document. StrataEMR includes the selected QDCs on the Medicare claim automatically.