2019 MIPS: Interpret the Summary Compliance Report

Compliance Report by Therapist

Your Summary Compliance Report shows how each therapist is performing and can be sorted several different ways. Best practice is to view this report sorted by Therapist in order to ensure there is no missing information, such as therapist NPI. Look for trends and patterns such as Therapists who are disqualifying many patients, low MQF assignment or high non-compliance rates. It could be that the Therapist needs to work with a different type of patient or they need assistance in learning to provision PROS.

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Items to validate for submission and insights going into 2020:

  • Noncompliance rate – to satisfy the 2019 data-completeness requirement of 60% from Medicare, non-compliance should be less than 39%.
  • If non-compliance rate is higher than 39%, review your patient level report in detail to ensure patients who should have been disqualified are indeed, disqualified.
  • Only patients who meet MIPS Exclusion Requirements are eligible for disqualification.