Managing Practice MIPS Settings

The settings described on this page apply to all providers within the practice.

  1. Log in to the Encompass web application as an administrator.
  2. Locate the Firm Settings group and click Manage Firm Settings.

    The Manage Firm Settings page opens.

By default, Category II CPT codesClosed 5-digit alpha-numeric codes that receive no payment. They are typically reported to Medicare to indicate quality of care and outcomes. Also known as PQRS, Level II, or HEDIS codes. are autocoded for Medicare patients only because historically claims-based MIPSClosed Merit-based Incentive Payment System. A program that incentivizes healthcare providers to improve the quality of care they deliver to Medicare patients. quality reporting was based only on Medicare claims. However, as more insurance carriers require Category II CPT codes for HEDISClosed Healthcare Effectiveness Data and Information Set (HEDIS) reporting is used to measure how well a health plan performs in areas of quality of care, access to care, and member satisfaction with the plan itself. Eyecare providers participate by reporting CPT Category II codes. reporting, it may become necessary to enable Category II coding for all patients.

Enabling MIPS autocoding for all patients causes Category II CPT codes to be transmitted to the practice management system regardless of the patient's insurance carrier. The practice management system may suppress Category II CPT codes on the claim.

  1. Navigate to the Firm Settings page.
  2. Locate the Use MIPS Auto-Coding options.
  3. Select All Patients to enable Category II CPT codes regardless of insurance carrier

    OR

    Select Medicare Patients Only to limit Category II CPT codes to Medicare patients.

  4. Click Save.