The Merit-based Incentive Payment System (MIPS) plays a critical role in how Medicare reimburses healthcare providers. But with evolving rules, tedious documentation requirements, and time-consuming manual reporting, many organizations struggle to fully realize the benefits of the program. That means lost revenue, missed opportunities, and mounting frustration for providers.
At MediMobile, we believe maximizing MIPS shouldn’t be complicated. That’s why we built Genesis—our AI-powered platform that automates the entire MIPS tracking and reporting process. Whether you're new to MIPS or looking to improve your current compliance strategy, this guide will show you how to start strong and stay ahead.
MIPS evaluates performance in four key categories:
This category measures how well providers deliver care based on patient outcomes. It includes metrics derived from ICD-10 codes, CPT codes, demographics, and place of service—and is the most heavily weighted section in traditional MIPS programs.
This component evaluates how effectively a provider uses electronic health records (EHRs) to improve patient care. Some provider types, such as small practices and hospital-based clinicians, may be exempt from this category.
This category rewards clinicians for engaging in activities that enhance care processes, coordination, and patient engagement. Requirements vary depending on practice size and whether providers report through traditional MIPS or MIPS MVP (MIPS Value Pathways).
This section measures the cost of care based on Medicare Part B claims. No additional submissions are needed—CMS automatically calculates your performance based on existing claims data.
Each of these categories is weighted and contributes to your MIPS Final Score, which in turn impacts your Medicare reimbursements.
To determine if you’re required to report, the QPP uses a low-volume threshold based on your Medicare Part B claims. You must participate in MIPS if you meet all three of the following criteria:
If you meet these thresholds, staying compliant—and maximizing your score—is essential for protecting your revenue.
MIPS compliance requires more than good clinical care—it demands accurate, timely documentation and constant attention to shifting regulations. Even high-performing practices may underperform in MIPS due to the following issues:
Every MIPS measure has specific documentation requirements. A missed field, incomplete note, or unrecorded follow-up can prevent a measure from qualifying.
Example: For diabetes management, you may need to document lab results, eye exams, and counseling. If one piece is missing, you lose credit for that measure.
CMS updates MIPS measures, scoring criteria, and submission methods every year. Staying current takes time and expertise many practices don’t have.
Most practices are already stretched thin. Tracking MIPS measures manually adds pressure to already-overloaded clinicians and administrators.
When data lives in silos—EHRs, billing systems, practice management tools—it’s hard to gather the full picture needed for MIPS reporting.
Many providers focus only on familiar MIPS measures, overlooking easier or more rewarding options they could qualify for. That means leaving potential incentive dollars on the table.
Here’s how Genesis simplifies MIPS compliance:
Genesis analyzes real-time clinical documentation to identify eligible MIPS measures based on what providers are already doing.
Example: A provider documents a smoking cessation session. Genesis instantly connects that action to the appropriate MIPS measure—ensuring you get credit.
Genesis integrates directly with your EHR and billing systems, pulling together everything needed for accurate MIPS reporting. No more chasing down files or reconciling platforms.
Genesis highlights gaps in documentation before reports are submitted—giving providers the chance to fix errors in the moment.
Track your MIPS performance across all four categories with user-friendly dashboards that provide instant insights and help prioritize areas for improvement.
When it’s time to report, Genesis generates CMS-compliant reports that are complete, accurate, and ready to go. Say goodbye to spreadsheets and manual uploads.
✅ Higher Medicare Reimbursements
By capturing every possible measure and avoiding penalties, you’ll secure the highest allowable incentive.
✅ Improved Compliance
Real-time alerts and smart workflows mean fewer mistakes, missed measures, or rejected reports.
✅ Time Back in Your Day
Automation frees clinicians and coders from tedious admin work so they can focus on patient care.
✅ Confidence and Clarity
With Genesis dashboards and reports, you always know where you stand—and what to improve.
Before Genesis:
A small practice manually tracks MIPS measures across multiple spreadsheets. Despite providing quality care, they miss documenting a number of qualifying activities—resulting in a lower score and reduced Medicare reimbursement.
With Genesis:
As providers document in real time, Genesis flags eligible MIPS measures, suggests improvements, and generates a compliant report. The practice earns a higher score, full reimbursement bonuses, and cuts hours off administrative tasks.
Don’t let MIPS become another headache. With Genesis, you can streamline compliance, protect your revenue, and simplify your workflow—all from one intelligent platform.
👉 Schedule a personalized demo today on our calendar below to see how Genesis makes MIPS easy.