Why MIPS Reporting Still Matters in 2025

Many providers assume that without a certified Electronic Health Record (EHR), they cannot participate in the Merit-Based Incentive Payment System (MIPS). This misconception can be costly, leading to missed incentives and penalties as high as 9% on future Medicare reimbursements.

With CMS raising the MIPS performance threshold each year, failing to report puts providers at serious financial risk. The good news: even without an EHR, there are two clear pathways to meet CMS requirements and protect your bottom line.

Option 1: Claims-Based MIPS Reporting

For solo practitioners and small practices (≤15 clinicians), Claims-Based Reporting is the most straightforward path.

• How it Works:
  Quality measures or a MIPS Value Pathway (MVP) are reported directly through Medicare Part B claims using Quality Data Codes (QDCs) or modifiers.
• Advantages:
  • No additional fees
  • Simple, low-cost entry point
  • Designed for small practices and solo providers
• Limitations:
  • Only applies to the Quality category
  • Risk of missed codes resulting in lost credit

Best for solo providers or very small practices seeking a cost-effective solution.

Option 2: Registry MIPS Reporting

Registry Reporting is more comprehensive and preferred by many providers without an EHR.

• How it Works:
  Data is extracted from billing software or paper charts, compiled in spreadsheets, and uploaded into a CMS-approved Qualified Registry or QCDR.
• Advantages:
  • Covers multiple categories: Quality, Improvement Activities, and (where applicable) Promoting Interoperability
  • Reduces risk of missed coding
  • More reliable than claims-only reporting
• Considerations:
  • Registry fees typically start at ~$350–$500 per provider
  • Requires additional setup and data submission processes

Best for providers seeking a robust, reliable, and compliant reporting solution.

Choosing the Right Pathway

• Solo providers may benefit from the simplicity of claims-based reporting.
• Growing practices may find registry reporting worth the investment for its reliability and broader category coverage.

The most important takeaway: not having an EHR does not exclude you from MIPS. Both options keep you compliant, help avoid Medicare penalties, and open the door to performance-based incentives.

How TriumpHealth Supports MIPS Success

At TriumpHealth, we partner with providers to ensure seamless MIPS reporting in 2025. Our expert consultants help you:

• Select the right measures or MVP for your specialty
• Ensure documentation and coding meet CMS requirements
• Manage data collection, validation, and timely submission
• Optimize scores to avoid penalties and maximize incentives

Whether you report through claims, a registry, or an EHR, TriumpHealth MIPS consulting team ensures compliance and helps you turn reporting into a strategic advantage. Unsure which option fits your practice? Schedule a Consultation with MIPS experts, or contact us at [email protected] or call (888) 747-3838 x0.