MIPS & MACRA Reporting

MIPS & MACRA Compliance
for Dermatology Practices

MIPS scores determine your Medicare payment adjustments — up to ±9% per year. For a $2M Medicare practice, that's a $360,000 swing over four years. We manage the full MIPS reporting lifecycle so your practice consistently scores in the exceptional performance tier.

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Payment Adjustment Range
-9%
Low
+9%
Exceptional

$2M Medicare practice = $360,000 swing over 4 years between low and exceptional performance.

Scoring Framework

The Four MIPS
Performance Categories

📊

Quality — 30%

Report 6 measures. Derm-specific options include melanoma recall (137), biopsy follow-up (265), and BCC/SCC turnaround (462).

💻

Promoting Interoperability — 30%

EHR meaningful use attestation, security risk analysis, e-prescribing, and patient electronic access documentation.

💰

Cost — 25%

CMS-calculated from claims — no direct submission required. Covers Total Per Capita Cost and Medicare Spending Per Beneficiary.

📈

Improvement Activities — 15%

Attest to practice improvement activities. High-weighted activities count double. Derm-relevant options include care coordination and telehealth.

Quality Measures

Dermatology-Specific MIPS
Quality Measures

Choosing the right measures and documenting them correctly is where most derm practices leave MIPS points on the table. These are the QPP measures most directly applicable to dermatology.

MeasureName & DescriptionType
137Melanoma: Continuity of Care — Patient Recall System
Patients with new melanoma who have a follow-up recall system established. Demonstrates coordinated, proactive cancer surveillance.
Outcome
138Melanoma: Coordination of Care — Staging Documentation
Patients with new melanoma who have pathologic staging documented for continuity with oncology and surgical subspecialists.
Process
224Melanoma: Overutilization of Imaging Studies
Stage 0–IIA patients who did not have imaging studies ordered. Rewards evidence-based, guideline-consistent ordering practices.
Efficiency
265Biopsy Follow-Up: Communication to Referring Clinician
Biopsy results documented and communicated to the ordering clinician. Applies broadly — one of the highest-volume derm reporting opportunities.
Communication
462BCC & SCC Biopsy Reporting Turnaround — Pathologist to Clinician
Timeliness of biopsy result communication for basal cell and squamous cell carcinoma. Encourages structured pathology reporting workflows.
Timeliness
Full-Service Management

Everything We Handle
For Your Practice

Annual eligibility determination & exclusion analysisWe confirm MIPS status and identify small practice exemptions or hardship exceptions that may apply.
Quality measure selection optimized for your patient mixWe map your EHR data to highest-scoring measures and identify documentation gaps before submission deadlines.
EHR data extraction & QPP portal submissionDirect integration — no manual data entry.
Improvement Activity selection & attestationWe identify high-weighted activities applicable to your practice and handle full documentation.
Promoting Interoperability documentation & attestationSecurity risk analysis, e-prescribing, patient access, and health information exchange — prepared and submitted.
Mid-year performance monitoring & score projectionsWe track your score throughout the performance year and alert you to gaps before the window closes.
QPP feedback report review & appeal supportWe review your annual QPP report and manage any resubmissions or appeals to improve your final score.
APM pathway eligibility assessmentFor qualifying multi-provider groups, we assess Advanced APM eligibility — which can exempt from MIPS and add a 5% lump-sum incentive.

MACRA: What Changed

The Medicare Access & CHIP Reauthorization Act (2015) replaced the SGR formula and created two tracks. Most dermatologists participate through MIPS, which scores performance annually and applies a payment adjustment two years later.

MIPS Track: Annual scoring with ±9% payment adjustment.

APM Track: Qualifying participants are exempt from MIPS and receive a 5% lump-sum incentive annually.

EHR Compatibility

We extract MIPS data directly from your EHR — no manual data entry.

Stop leaving MIPS money
on the table.

We'll review your current score, identify missed reporting opportunities, and show you exactly what an optimized MIPS strategy looks like for your practice — free, within 5 business days.