Guest Post: Promoting MIPS to improve patient care, practice revenue and Medicare compliance
Josh White, DPM CPed recently wrote a great article on how a practice can integrate a comprehensive diabetic foot exam into their patient workflows and optimize their MIPS measure reporting:
“One of the best ways to leverage the financial benefits of MIPS is to use quality reporting as a driver of best practice protocols.
Six quality measures must be reported to avoid a 5% penalty in 2018; this increases to 9% based on 2020 reporting. Two of the six quality measures, 126 and 127, can be easily reported by performing a comprehensive diabetic foot exam on all patients 65 and over with diabetes. When examination determines there is a condition that increases the risk for ulceration and if treatment or counseling is provided, it may be appropriate to bill this visit as a 99213 level E&M.
An average practice has 250 Medicare patients with diabetes. Most likely 75% (185 patients) will demonstrate a condition that warrants management and could quality for 99213 billing. These patients will most likely qualify for and should be prescribed therapeutic footwear.
Billing: $60 evaluation and management visit + $215 shoes+inserts = $275* $275 X 185 patients = $50,875/year net additional income.
*average reimbursement for shoes + 3 pairs of diabetic inserts”
Josh White has written on MIPS from the perspective of patient care, Medicare compliance and revenue generation. Below are some posts on his HealthyOutcomes blog:
- “Delegate and Elevate” When Need for Shoe Fitting Exceeds Practice Capacity
- A Testimonial to How Using EOS Can Improve Practice Productivity and Growth
As an EOS implementor, Dr. White offers a solution to practices needing structure and accountability to capitalize on opportunities in the rapidly transforming health care environment.