MIPS Consulting & Penalty Protection
Up to 9% of Your Medicare Revenue Rides on One Score.
MedVersify's MIPS consultants own the whole program for you — eligibility, measure strategy, year-round score tracking, and audit-ready submission to CMS — so the adjustment on your payments is a bonus, not a penalty.
- All specialties
- No long-term contracts
- Nationwide
MIPS Penalty Calculator
What Is a Failed Submission Worth at Your Practice?
Max penalty · −9%
−$288K/Year
withheld across one payment year
That is
−$24K/Month
out of your remittances every month
Score above 75 instead, and the adjustment flips positive — funded by the practices that fell short.
Protect This Revenue — Free AssessmentNo obligation · Response within 24 hours
75 pts
To Break Even
Threshold locked through 2028
~1 in 8
Clinicians Penalized
CMS estimate of negative adjustments
6
Measures Decide Your Score
Quality alone is 30% of the composite
2 Years
Until Penalties Land
Performance year to payment adjustment
New to the Program?
What Is MIPS, in Plain English?
MIPS — the Merit-based Incentive Payment System — is how Medicare grades and pays clinicians on performance. Created by the MACRA law in 2015 and run by CMS as part of the Quality Payment Program, it replaced a patchwork of older reporting programs with a single annual score.
Each year, eligible clinicians are scored from 0 to 100 across four weighted categories — Quality, Cost, Promoting Interoperability, and Improvement Activities. That composite score then raises or lowers every Medicare Part B payment the practice receives two years later, by as much as 9% in either direction.
Participation is not optional for most practices: clinicians who bill Medicare above certain volume thresholds are automatically required to report, and not reporting at all is scored as a zero — the maximum penalty. In short: if your practice sees Medicare patients, MIPS is already affecting what you get paid, whether anyone is managing it or not.
Who it applies to
Physicians, NPs, PAs, and other clinician types who exceed all three Medicare low-volume thresholds — decided per TIN/NPI combination.
What gets measured
A 0–100 composite score across four categories: Quality (30%), Cost (30%), Promoting Interoperability (25%), and Improvement Activities (15%).
What it changes
Every Medicare Part B payment, two years after the performance year — an adjustment from −9% up to a positive bonus.
Why it catches practices off guard
The two-year lag between performance and payment means a quiet reporting gap today becomes a visible revenue cut in two years.
How MIPS Pays — or Charges
Every Composite Score Lands Somewhere on This Line
The Merit-based Incentive Payment System converts your 0–100 score into an adjustment applied to every Medicare Part B payment — roughly two years after the performance year. The break-even line sits at 75.
The catch: a skipped or late submission is scored as zero — the far-left of the line — no matter how good the care behind it was. Most penalties are administrative, not clinical. That is the problem this service removes.
What We Manage
One Score, Four Categories — Each Handled for You
Your composite score is weighted across four categories with different rules, windows, and failure modes. Our consultants make sure each one adds points instead of silently subtracting them.
Quality
30% of score
Six measures decide most of your score. We pick them from CMS benchmark deciles — not from what your EHR happens to track — and watch the 75% data completeness floor all year.
Cost
30% of score
Scored by CMS straight from Medicare claims — nothing to submit, plenty to influence. We flag the coding and documentation patterns that drive your cost attribution.
Promoting Interoperability
25% of score
One wrong Security Risk Analysis attestation zeroes the whole category. We manage the 180-day window, both required attestations, and your EHR certification check.
Improvement Activities
15% of score
We attest only to activities your practice genuinely runs — documented during the 90-day window, not reconstructed for an auditor later.
The MedVersify Method
From Penalty Exposure to Positive Adjustment, in Four Phases
A strong MIPS score is engineered in January, not rescued in March.
Eligibility & Exposure Review
Every TIN/NPI combination on your roster checked: who must report, who is exempt, and what this year is worth in dollars.
Benchmark-Driven Measure Strategy
Your six quality measures selected against live CMS benchmark deciles — where maximum points are realistically reachable.
Year-Round Score Monitoring
Data completeness, category windows, and a projected composite score tracked continuously — with alerts while course-correction is still possible.
Audit-Ready Submission
Every data point audited against source documentation, submitted via registry or the QPP portal, with CMS acceptance confirmed in writing.
Measure strategies tuned per specialty
- Primary Care
- Cardiology
- Behavioral Health
- Orthopedics
- Gastroenterology
- Oncology
- Urology
- Radiology
- Pathology
- Podiatry
- Vascular Surgery
- Neurology
- OB/GYN
- Neuropsychology
- Interventional Radiology
Scope of Service
Everything Between You and a Clean Submission
MIPS touches more than the reporting portal. Quality scores are built on the clean claims and documentation our medical billing team produces, eligibility presumes the active Medicare enrollment our credentialing specialists maintain, and the 75% data completeness floor rewards the steady patient volume good scheduling delivers. We manage MIPS with all three in view.
- TIN/NPI-level eligibility verification
- Group vs. individual reporting analysis
- Quality measure selection & benchmarking
- eCQM and specialty measure set support
- Security Risk Analysis attestation support
- Improvement Activities documentation
- Mid-year composite score projections
- Registry / QPP portal submission
- Pre-submission data audit
- Post-score review & next-year strategy
Are you even required to report?
Only clinicians exceeding all three thresholds — in both CMS determination segments — must participate. And it is decided per TIN/NPI pairing, so one physician can hold different obligations at different practices.
Exempt but close to the thresholds? Opting in voluntarily can still earn a positive adjustment — we verify every pairing on your roster before recommending either path.
The Dates That Cannot Slip
One Performance Year, Six Hard Deadlines
- Jan 1
Performance year opens
Quality and cost data start counting immediately.
- Jun 30
CAHPS registration closes
Groups electing the patient experience survey must be registered.
- Jul 5
Last viable PI start
After this, the 180-day minimum window no longer fits the year.
- Oct 2
Last viable IA start
Final day a 90-day Improvement Activity can still complete.
- Dec 31
Performance year closes
Whatever gaps exist at midnight are permanent.
- Mar 31
Submission deadline
Late is scored as non-submission: automatic maximum penalty.
Several of these are points of no return: once a minimum collection window can no longer fit before December 31, the points it protected are gone. We run this calendar so your team never has to.
Results Practices Talk About
What Changed After Practices Handed Us MIPS
Their MIPS team got us to an Exceptional Performance score. We earned a positive adjustment instead of facing a penalty we had no idea was coming.
Dr. Raj Patel, MD
Cardiology Group · Chicago, IL
We had been submitting MIPS ourselves for three years and never broke 70 points. MedVersify reviewed our measure selection in week one and identified the problem immediately.
Dr. Anita Sharma, MD
Internal Medicine · Houston, TX
The penalty exposure on our Medicare volume was significant. Knowing MedVersify is managing it lets us focus on clinical operations.
Michael Torres
COO, Multi-Specialty Group · Atlanta, GA
Get Started
Hand MIPS to a Team That Does Nothing Else
Tell us about your practice, and a MIPS consultant will come back within one business day with your eligibility picture and a candid read on where your score stands.
Mon – Fri, 9am–5pm EST
(507) 312-9282Email our MIPS consultants
info@medversify.com- No long-term contracts required
- A dedicated MIPS consultant assigned to your practice
- Every specialty and practice size, nationwide
- Works alongside your existing billing and EHR setup
Request a Free Consultation
Message Received
A MedVersify specialist will review your request and reach out within 24 business hours.