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What Do the MIPS Physical Therapy Developments Mean for You?

Let’s face it – every physical therapist got used to submitting PQRS data over the past couple of months. And even though this was seen as a ‘big and revolutionary change’, there are more novelties coming on the market.

As of recently, CMS decided to shut down the PQRS data submissions and replace them with a brand new, much larger data reporting initiative known as the Merit-Based Incentive Payment System (MIPS).

MIPS went into effect on January 1st this year and according to the CMS, is a great way to “earn a payment adjustment based on evidence-based and practice-specific quality” data. The change won’t be into effect up until 2019.

And if you are wondering what will it mean for physical therapists, we are listing the answers below.

1. Quality Reporting Measures Which Are Similar to PQRS

First and foremost, no one needs to be too dramatic about the PQRS measures that have now been changed. The truth is, while MIPS entirely replaces PQRS, there are similarities as well.

Most of the providers are now required to report at least six measures - across combinations of quality domains - including one outcome measure.

2. Quality And Improvement

Aside from the daunting task of adapting to a new platform experience, every physical therapist must accept the fact that MIPS brings a lot of improvements in terms of quality and the activities (which are now a reporting component).

3. Criteria Changes

CMS increased the minimum thresholds for eligible provider participation, in which from now on “eligible clinicians with less than or equal to $90,000 in Part B are allowed changes or less than or equal to 200 Part B beneficiaries”. As of now, there is no opt-in option for providers who are excluded which means that even if you are running a small rehab therapy practice, you need to participate in MIPS on a voluntary (rather than mandatory) basis in order to reap the financial benefits of the program.

4. Reaping The Financial Benefits

As we already mentioned, there are a lot of financial benefits one can reap with the MIPS. In addition to the annual adjustment to the Part B fee schedule (+.5% through 2019; then +.25% in 2026 and beyond) and the value based payment adjustment based on final score, providers can also face some reputation implications.

5. Group Reporting Opportunities

All of the individual providers and small practices which don’t meet the minimum threshold for MIPS participation may also be eligible for group reporting - all thanks to the new “virtual group reporting” option which lets professionals virtually participate together in MIPS for a specific timeframe.

In the end, the recent MIPS developments are paving the way to a lot of new changes and improvements in the field of physical therapy. If you want to learn more about this type of eligibility, visit this link.

HENO stays current and up to date on all changes for PT, OT and speech therapists; you no longer have to worry about missing requirements for insurance purposes.

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