Disqualify a Patient from MIPS Submission

Patients will be automatically removed from the MIPS registry if they:

    • Are under the age of 18 years old
    • Are not under treatment related to one of the 5 CMS-approved measures (LEFS, MDQ, NDI, KOS, QDASH)
    • Do not complete 2 or more forms for an assigned measure  
  • Please note that this does not set the "Disqualified" toggle in the patient Episode of Care. The patient will be excluded from MIPS reporting registry only if they fall under the above criteria. 

Patients can be manually disqualified from MIPS if they:

    • Are non-English speaking and translation services are unavailable
    • Are unable to read
    • Unable to accurately complete the MIPS PRO due to a mental or cognitive impairment
    • Patients meeting medicare requirements for maintenance therapy, such as the maintenance of functional status or prevention of slow deterioration in function, as defined by the Medicare Benefits Policy Manual, Chapter 15
    • Are determined to be extremely medical complex and likely to make poor clinical progress based on the experience and clinical judgment of the treating clinician  


For additional information on how to qualify/disqualify a patient review the following article: 

Qualifying a Patient for MIPS