Over 60% of clinicians reported little or no familiarity with MIPS in early surveys, leading to revenue loss. Macralytics’s certified MIPS consultants manage your reporting and partner with you to maximize your revenue collection.
MIPS reporting helps practices collect and submit performance data to CMS under the Merit-Based Incentive Payment System. Through this program, your practice either earns bonuses or incurs penalties on future Medicare reimbursements.
When MIPS reporting is done right, practices see the difference. You will face fewer revenue risks and greater recognition for quality care under Medicare Part B.
For Medicare Part B providers, understanding MIPS eligibility early can also help you avoid compliance issues. You are eligible for MIPS reporting if you:
To evaluate performance, CMS analyzes each practice across four categories. All metrics together form your final MIPS composite score (0–100 points), which directly impacts your Medicare Part B reimbursements in the 2028 payment year.
It measures how effectively clinicians deliver evidence-based and patient-centered care. Participants must report 6 quality measures, including at least one outcome or high-priority measure. Performance is compared against national benchmarks to determine the score.
This measure evaluates how well clinicians manage resources while delivering quality outcomes. CMS calculates this score using Medicare claims data, without needing separate reporting. It assesses spending patterns and cost efficiency across various episodes of care.
The IA category rewards clinicians for implementing practice-based initiatives that improve care coordination. Participants can select from over 100 activities, such as integrating behavioral health. Completing high-weighted activities earns points toward the final MIPS score.
It focuses on advancing the use of certified electronic health record technology. This category measures how clinicians exchange health information and use e-prescribing. PI has a 90-day minimum reporting period, and you need to report measures under the specified objective.
Our expert, Dr. Attiya Saqib, is an AAPC-trained MIPS consultant who will carefully guide you through the entire reporting process. She leads our specialized MIPS reporting team at Macralytics to counsel practices nationwide. Our team makes sure that your performance data works for you, not against you.
Many eligible providers miss out on incentives simply because their reporting is not accurate or timely. With Macralytics’s MIPS consulting services, you can turn eligibility into opportunity and protect your Medicare reimbursements.
With Macralytics’s MIPS services, providers no longer struggle with complex CMS requirements. Experts handle every step of your MIPS reporting process, as explained below:
Our team confirms your MIPS eligibility based on CMS criteria such as Medicare billing, patient volume, and provider type. We use the CMS QPP Participation Lookup Tool to verify eligibility.
We identify the highest-scoring quality measures for your specialty. Our MIPS reporting consultants carefully perform strategic measure selection to boost your incentive potential.
Throughout the performance year, we track real-time data from your EHR, billing, and clinical systems. Ongoing monitoring allows frequent adjustments before submission deadlines.
Before submission, our MIPS consultants review data for accuracy and compliance. This crucial step minimizes MIPS reporting errors that could lead to score reductions or CMS audits.
Being your MIPS partner, Macralytics handles every timely submission through approved CMS portals. Our MIPS team ensures that your data meets all CMS validation requirements.
CMS reviews the data and assigns a final MIPS score (0 to 100). We then analyze this score to identify improvement areas and help you earn higher results in the next reporting cycle.
For the 2026 performance year, MIPS adjustments depend on your final score.
CMS finalized the 2026 QPP Final Rule on November 5, 2025, keeping category weights unchanged. CMS added 5 new quality measures for 2026. Thirty existing measures received substantive updates. Claims-based measures now use median-based scoring with standard deviations. This revised methodology benefits practices with moderate performance rates.
The TPCC attribution rules changed for specialty groups. Advanced practice practitioners no longer trigger cost attribution unfairly. CMS retired the “Achieving Health Equity” IA subcategory. The replacement is “Advancing Health and Wellness.”
PI reporting now requires dual Security Risk Analysis attestation under HIPAA. CMS adopted a measure suppression policy granting full credit for suppressed measures. The eCR measure is suppressed for 2025 reporting. Six new MVPs launched, covering radiology, pathology, podiatry, and vascular surgery.
With its MIPS reporting and consulting services, Macralytics maximizes your reimbursement potential. Our certified experts don’t just submit your data, we provide the following benefits:
With Macralytics, you enjoy continuous tracking, feedback, and optimization instead of last-minute data submissions.
You get to work with our AAPC-certified professionals who deeply understand MIPS rules and measure requirements.
Our MIPS reporting consultants make strategies to fit your specialty’s unique clinical and reporting needs.
Macralytics acts as an extension of your team to offer continuous support to help your practice meet your MIPS goals.
Ready to improve your MIPS performance and maximize incentives? Connect with our experts for personalized guidance today.
info@macralytics.com
+1 (647) 855-6252
Providers need to submit EHR performance reports, quality measure data, improvement activity evidence, and attestation forms for MIPS reporting. Keeping detailed records helps validate submissions and protect your practice during CMS audits or reviews.
Failing to meet the MIPS submission deadline can have significant financial repercussions. CMS will assign a zero score for non-submission, leading to the maximum negative payment adjustment of up to –9% on your future Medicare reimbursements.
The 2026 MIPS performance year runs from January 1 to December 31, 2026. You must submit all data to CMS by March 31, 2027. NRDR Missing this deadline triggers an automatic –9% Medicare Part B payment adjustment for the 2028 payment year.
You can revise or correct your MIPS data anytime within the CMS submission window. However, after the deadline (typically March 31), no further changes are allowed. During the open submission period, you may update or withdraw data to resolve inaccuracies and enhance your final MIPS score.
