MIPS Claims Submission: A Thing of the Past in 2025

As the healthcare landscape continues to evolve, 2025 marks a significant shift in the Merit-based Incentive Payment System (MIPS) reporting process. One of the major changes this year is the discontinuation of the claims submission method for small practices. This decision by the Centers for Medicare & Medicaid Services (CMS) has left many small offices scrambling to adjust their MIPS reporting strategies. In this blog, we’ll explore what this change means and how small practices can adapt to remain compliant and successful under MIPS.

Why MIPS Claims Submission Is Being Eliminated

The claims-based reporting method has long been a staple for small practices, primarily because it was straightforward and integrated with existing billing processes. However, CMS has decided to phase out this option due to concerns about data quality, reporting accuracy, and alignment with broader healthcare interoperability goals. Claims-based reporting often resulted in incomplete data, making it challenging for CMS to evaluate performance comprehensively.

Instead, CMS is encouraging providers to adopt more robust reporting methods, such as:

• Registry Reporting

• Electronic Health Record (EHR) Integration

• Qualified Clinical Data Registry (QCDR)

• Web Interface (for larger groups)

  
  

The Impact on Small Practices

The elimination of claims submission will undoubtedly create hurdles for small practices. Here are some of the key challenges and implications:

1. Increased Administrative Burden

Small practices often operate with limited staff and resources. Transitioning to alternative reporting methods like EHR or registry-based submissions may require additional time, effort, and training. This added administrative burden can detract from patient care, which is already a top concern for many independent providers.

2. Cost Implications

Alternative reporting methods may involve costs that small practices aren’t accustomed to. For example, subscribing to a Qualified Registry or upgrading EHR systems to meet reporting requirements can be financially burdensome. Practices may need to weigh these costs against the potential penalties for non-compliance.

3. Learning Curve

For practices that relied on the simplicity of claims submission, adopting a new reporting method will require time to understand and implement. This includes learning how to use new software, selecting appropriate measures, and ensuring data accuracy.

4. Risk of Non-Compliance

With claims submission off the table, small practices that fail to adapt could face increased penalties for not reporting. These penalties can significantly impact their revenue, particularly for practices already operating on thin margins.

Adapting to the New Normal

While the elimination of claims submission is challenging, it’s not insurmountable. Here are steps small practices can take to ease the transition:

1. Leverage MIPS Consulting Services

MIPS consultants can provide tailored guidance to help small practices navigate this change. From selecting the right reporting method to ensuring compliance, consultants can save practices time and reduce stress.

2. Upgrade Technology

Investing in EHR systems that support MIPS reporting or partnering with a Qualified Registry can streamline the process. Many of these platforms offer user-friendly interfaces and real-time feedback to help practices meet their goals.

3. Focus on Education

Training staff and providers on the new reporting methods is crucial. Education sessions can ensure that everyone involved understands their role in the MIPS reporting process, reducing errors and increasing confidence.

4. Start Early

Procrastination is the enemy of success. Begin transitioning to a new reporting method as soon as possible to allow ample time for troubleshooting and adjustments.

Why This Change Could Be Beneficial

Although the loss of claims submission is initially disruptive, it could lead to long-term benefits for small practices. Alternative reporting methods often provide more detailed and accurate data, enabling practices to:

• Identify areas for improvement

• Enhance patient care

• Increase their chances of earning positive payment adjustments

  
  

Additionally, these changes align with the broader shift toward value-based care, which rewards providers for quality and outcomes rather than volume.

The end of claims submission for MIPS reporting in 2025 marks a new era for small practices. While the transition will require effort and investment, it also presents an opportunity to modernize and improve reporting processes. By taking proactive steps and seeking the right support, small practices can continue to thrive under the MIPS program and protect their revenue from penalties.

Need help navigating these changes? Premier MIPS Consulting specializes in simplifying MIPS for small practices. Reach out today to learn how we can help you cut through the red tape and succeed in 2025 and beyond.

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