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May 24, 2022 9:15:00 AM Sarah Reiter

CMS Requirements for MIPS 2022: What’s at Stake?

In 2022, the Merit-based Incentive Payment System (MIPS) program is even more complex than it has been in the past.  By law, the program is structured such that 1 out of every 2 clinicians will be penalized up to 9% each year. Many elements carry forward from 2021, including the requirements to submit a full year’s data to meet data completeness and stringent timeline requirements for Promoting Interoperability and Improvement Activities categories. Beyond that, its critical to be aware of and understand the implications of changes for the 2022 MIPS reporting period as failure to comply or earn enough points will result in penalties. There’s a lot at stake for medical practitioners this year and beyond. 

Important Changes for MIPS 2022 

There are several key areas that require focus in this year’s program including: 

#01: You must earn at least 75 out of the possible 100 MIPS points to avoid the 9% penalty.  

The increase of the minimum threshold to avoid a penalty from 60 in 2021 to 75 points in 2022 represents the fifth straight year of threshold increases.  This movement is intentional to meet the requirements of the law which state that the threshold must be set at the median in 2022, meaning 50% of all clinicians will be penalized each year.   

#02: There are significant changes to quality measures. 

In an effort for The Centers for Medicare & Medicaid Services (CMS) to achieve their goals through the MIPS program, they actively change and update measure definitions, often done at any time throughout the year and with no published notice.  In 2022, there are changes made to many quality measures, meaning that it may not be in your best interest to be focused on measures you have used in the past, and that measures used in the past may or may not still exist.    

#03: Improvement Activities category is no longer optional and is more relevant than ever before. 

Because of the 75 point threshold to avoid a penalty in this year’s MIPS program, clinicians must maximize their MIPS points earned in every category, including Improvement Activities (IA).  There are additional activities that are added this year making it more important than ever to have a strategy for meeting the requirements for IA.  

Benefits of a MIPS Reporting Partner 

Within this framework, it can still be challenging to know what to do to earn MIPS points, optimize your score, and protect your reimbursements given the many nuances and commonly misunderstood aspects within the MIPS program. The one thing you can control is the MIPS reporting partner and the corresponding reporting method you choose. In fact, given what’s at stake it’s critical to select a MIPS expert who can guide you to help optimize MIPS points and protect reimbursements.  


Here at Practice EHR, we get it; MIPS is a big challenge and we want to provide our clients with the most effective solution to help with compliance. Through our partnership with Health eFilings, our goal is to simplify this process for our clients and set them up to successfully manage and leverage their EHR data while maximizing Medicare reimbursements. Health eFilings is a certified electronic health record technology (CEHRT) and the national leader in automated MIPS reporting and can help you:  

  • Fully automate the MIPS process with an ONC-certified software that does all of the work without requiring IT resources, administrative support or workflow changes.  
  • Save you significant time with a turnkey submission process that maximizes the financial upside by earning you the most MIPS points.  
  • Have peace of mind knowing Health eFilings has a 100% success rate with CMS accepting electronic submissions on behalf of clients.  

If you have any questions about MIPS, or how Health eFilings can benefit your practice, don't hesitate to get in touch!  

Click here to learn more about how to maximize your MIPS reimbursement. 

Topics: MACRA/MIPS, Industry Update, Client Favorites




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