Guest Post: Promoting MIPS to improve patient care, practice revenue and Medicare compliance

Published by Christian Trygstad on

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”

About Josh White, DPM, CPed

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:

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.

Categories: MIPS