mips patient portal requirements what must the provider provide care plan diagnostic

by Dr. Jarvis Reilly DVM 4 min read

Provide Patients Electronic Access to Their Health …

32 hours ago  · Base Score (50% of the total) REQUIRES the participation of at least 1 patient in Portal activities such as accessing their information, receiving patient education, and messaging. One-Half of the Performance Measure (the remaining 50%) is based on patient engagement activities through the Portal. >> Go To The Portal


For the Provide Patients Electronic Access to Their Health Information measure, the required fields are: Provider's name and office contact information. Laboratory test report (s). Diagnostic image report (s).

Full Answer

Definition of Terms

API or Application Programming Interface: A set of programming protocols established for multiple purposes.

Reporting Requirements

NUMERATOR: The number of patients in the denominator (or patient authorized representative) who are provided timely access to health information to view online, download, and transmit to a third party and to access using an application of their choice that is configured meet the technical specifications of the API in the MIPS eligible clinician's CEHRT..

Scoring Information

Required for Promoting Interoperability Performance Category Score: Yes Measure Score: 40 points Eligible for Bonus Score: No

Additional Information

MIPS eligible clinicians must use 2015 Edition CEHRT. The 2015 Edition functionality must be in place by the first day of the performance period and the product must be certified to the 2015 Edition criteria by the last day of the performance period.

Regulatory References

For further discussion, please see the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) final rule: 81 FR 77228.

Certification Standards and Criteria

Below are the corresponding certification criteria and standards for electronic health record technology that support this measure.

What is MIPS in healthcare?

Merit Based Incentive Payments System (MIPS) is a payment track created under MACRA. It aims to link payments to the quality of care provided, improve care processes and health outcomes, increase the use of healthcare information, and reduce the cost of care.

What is bridge portal?

Bridge is a 2015 certified patient portal; therefore, healthcare organizations can use Bridge to promote interoperability for the Merit-Based Incentive Payment System (MIPS). With Bridge’s use, patients are provided timely access to view, download, and transmit their health information.

When was Medicare reauthorization?

On April 16, 2015 The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was signed into law. Under MACRA, providers caring for Medicare beneficiaries will be paid based on the quality of the care they provide.

When will Medicaid end in 2021?

2021. Promoting Interoperability: Medicaid⁷ will end on September 30, 2021. No payments⁸ will be made to any provider after 2021. There is a 90-day reporting period for both EHR and eCQM for all EPs⁹ to meet the incentive payment deadline of December 31, 2021.

How many times can a patient be seen in MIPS?

If a patient is seen by a MIPS eligible clinician more than once during the MIPS performance period, then, for purposes of measurement, that patient is only counted once in the denominator for the measure. All the measures relying on the term ‘‘unique patient’’ relate to what is contained in the patient’s medical record. Not all of this information will need to be updated or even be needed by the provider at every patient encounter. This is especially true for patients whose encounter frequency is such that they would see the same provider multiple times in the same MIPS performance period.

What is the denominator of MIPS?

Denominator#N#The number of unique patients seen by the MIPS eligible clinician during the performance period. #N#Numerator#N#Can be met one of two ways:#N#1. Documentation that the patient declined via the “Patient Declined” button.#N#2. Documentation that the patient has an “Active” patient portal. (See Details)

Definition of Terms

  • API or Application Programming Interface: A set of programming protocols established for multiple purposes. APIs may be enabled by a health care provider or provider organization to provide the patient with access to their health information through a third-party application with …
See more on mdinteractive.com

Scoring Information

  1. Required for Promoting Interoperability Performance Category Score: Yes
  2. Measure Score: 40 points
  3. Eligible for Bonus Score: No
See more on mdinteractive.com

Additional Information

  1. In 2022, MIPS eligible clinicians may use certified technology meeting the existing 2015 Edition certification criteria, updated to the 2015 Edition Cures Update, or a combination of the two, to me...
  2. To learn more about the 2015 Edition Cures Update and the changes to 2015 Edition certification criteria finalized in the 21st Century Cures Act final rule (85 FR 25642), we encou…
  1. In 2022, MIPS eligible clinicians may use certified technology meeting the existing 2015 Edition certification criteria, updated to the 2015 Edition Cures Update, or a combination of the two, to me...
  2. To learn more about the 2015 Edition Cures Update and the changes to 2015 Edition certification criteria finalized in the 21st Century Cures Act final rule (85 FR 25642), we encourage MIPS eligible...
  3. To check whether a health IT product has been certified to criteria updated for the 2015 Edition Cures Update, visit the Certified Health IT Product List (CHPL) at https://chpl.healthit.gov/.
  4. 2015 Edition or 2015 Edition Cures Update functionality must be used as needed for a measure action to count in the numerator during a performance period. However, in some sit…

Regulatory References

  1. For further discussion, please see the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) final rule:81 FR 77228.
  2. For additional discussion, please see the 2018 Physician Fee Schedule final rule – Quality Payment Program final rule: 83 FR 59789.
  3. In order to meet this objective and measure, MIPS eligible clinicians must use technology cer…
  1. For further discussion, please see the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) final rule:81 FR 77228.
  2. For additional discussion, please see the 2018 Physician Fee Schedule final rule – Quality Payment Program final rule: 83 FR 59789.
  3. In order to meet this objective and measure, MIPS eligible clinicians must use technology certified to the criteria at 45 CFR 170.315 (e)(1), (g)(7), (8) or (g)(10), and (9).

Certification Standards and Criteria

  • Information about the corresponding certification criteria for electronic health record technology that support this measure can be found below: Certification Criteria: Information about certification for 2015 Edition CEHRT can be found at the links below: §170.315(e)(1) View, Download, and Transmit to 3rd Party §170.315(g)(7) Application Access — Patient Selection §1…
See more on mdinteractive.com

Definition of Terms

  • API or Application Programming Interface: A set of programming protocols established for multiple purposes. APIs may be enabled by a health care provider or provider organization to provide the patient with access to their health information through a third-party application with more flexibility than is often found in many current “patient portals.” Provide Access: When a pat…
See more on mdinteractive.com

Reporting Requirements

  • NUMERATOR: The number of patients in the denominator (or patient authorized representative) who are provided timely access to health information to view online, download, and transmit to a third party and to access using an application of their choice that is configured to meet the technical specifications of the API in the MIPS eligible clinician'...
See more on mdinteractive.com

Scoring Information

  1. Required for Promoting Interoperability Performance Category Score: Yes
  2. Measure Score: 40 points
  3. Eligible for Bonus Score: No
See more on mdinteractive.com

Additional Information

  1. In 2021, MIPS eligible clinicians may use certified technology meeting the existing 2015 Edition certification criteria, updated to the 2015 Edition Cures Update, or a combination of the two, to me...
  2. To check whether a health IT product has been certified to criteria updated for the 2015 Edition Cures Update, visit the Certified Health IT Product List (CHPL) at https://chpl.healthit.gov/.
  1. In 2021, MIPS eligible clinicians may use certified technology meeting the existing 2015 Edition certification criteria, updated to the 2015 Edition Cures Update, or a combination of the two, to me...
  2. To check whether a health IT product has been certified to criteria updated for the 2015 Edition Cures Update, visit the Certified Health IT Product List (CHPL) at https://chpl.healthit.gov/.
  3. 2015 Edition or 2015 Edition Cures Update functionality must be used as needed for a measure action to count in the numerator during a performance period. However, in some situations the product ma...
  4. MIPS eligible clinicians are required to report certain measures from each of the four objectives, with performance-based scoring occurring at the individual measure-level. Each …

Regulatory References

  1. For further discussion, please see the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) final rule:81 FR 77228.
  2. For additional discussion, please see the 2018 Physician Fee Schedule final rule – Quality Payment Program final rule: 83 FR 59789.
  3. In order to meet this objective and measure, MIPS eligible clinicians must use technology cer…
  1. For further discussion, please see the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) final rule:81 FR 77228.
  2. For additional discussion, please see the 2018 Physician Fee Schedule final rule – Quality Payment Program final rule: 83 FR 59789.
  3. In order to meet this objective and measure, MIPS eligible clinicians must use technology certified to the criteria at 45 CFR 170.315 (e)(1), (g)(7), (8) or (g)(10), and (9).

Certification Standards and Criteria

  • Information about the corresponding certification criteria for electronic health record technology that support this measure can be found below: Certification Criteria: Information about certification for 2015 Edition CEHRT can be found at the links below: §170.315(e)(1) View, Download, and Transmit to 3rd Party §170.315(g)(7) Application Access — Patient Selection §1…
See more on mdinteractive.com

Definition of Terms

  • API or Application Programming Interface: A set of programming protocols established for multiple purposes. APIs may be enabled by a health care provider or provider organization to provide the patient with access to their health information through a third-party application with more flexibility than is often found in many current “patient portals.” Provide Access: When a pat…
See more on mdinteractive.com

Reporting Requirements

  • NUMERATOR: The number of patients in the denominator (or patient authorized representative) who are provided timely access to health information to view online, download, and transmit to a third party and to access using an application of their choice that is configured meet the technical specifications of the API in the MIPS eligible clinician's CEHRT. DENOMINATOR: The number of …
See more on mdinteractive.com

Scoring Information

  • Required for Promoting Interoperability Performance Category Score: Yes Measure Score: 40 points Eligible for Bonus Score: No Note: In order to earn a score greater than zero for the Promoting Interoperability performance category, MIPS eligible clinicians must: 1. Submit a “yes”to the Prevention of Information Blocking Attestations; and 2. Submit ...
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Additional Information

  1. MIPS eligible clinicians must use 2015 Edition CEHRT. The 2015 Edition functionality must be in place by the first day of the performance period and the product must be certified to the 2015 Editio...
  2. MIPS eligible clinicians are required to report certain measures from each of the four objectives, with performance-based scoring occurring at the individual measure-level. Each …
  1. MIPS eligible clinicians must use 2015 Edition CEHRT. The 2015 Edition functionality must be in place by the first day of the performance period and the product must be certified to the 2015 Editio...
  2. MIPS eligible clinicians are required to report certain measures from each of the four objectives, with performance-based scoring occurring at the individual measure-level. Each measure is scored b...
  3. Actions included in the numerator must occur within the performance period.
  4. More information about Promoting Interoperability performance category scoring is available on the QPP website.

Regulatory References

  • For further discussion, please see the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) final rule: 81 FR 77228. For additional discussion, please see the 2018 Physician Fee Schedule final rule – Quality Payment Program final rule: 83 FR 59789. In order to meet this objective and measure, MIPS eligible clinicians must use the capabilities and standards of CEHR…
See more on mdinteractive.com

Certification Standards and Criteria

  • Below are the corresponding certification criteria and standards for electronic health record technology that support this measure. Certification Criteria: Information about certification for 2015 Edition CEHRT can be found at the links below: §170.315(e)(1) View, Download, and Transmit to 3rd Party §170.315(g)(7) Application Access — Patient Selection §170.315(g)(8) Ap…
See more on mdinteractive.com