Medical Billing and Coding Services – CMS Update on MIPS

An Important CMS Update on MIPS Participation Under pressure from the MGMA and other physician advocacy groups, CMS will be sending letters to physician practices throughout the month of May with important, practice-specific information regarding eligibility to participate in the Merit-Based Incentive Payment System (MIPS) at the group/individual level for the performance year 2017.

Each Taxpayer Identification Number (TIN) enrolled to participate in the Medicare program will be receiving a letter that includes a summary of the Quality Payment Program (QPP), the steps towards participation and reporting, and the exemption eligibility guidelines.

• Being a low-volume clinician, identified by using historical Medicare claims data and defined by having less than $30,000 in annual Medicare Allowable charges or by treating fewer than 100 Medicare patients

• Not being among the categories of clinicians included in the program’s first year, i.e. therapists, audiologists, and others

• First-year Medicare enrolled clinicians

• Participants in certain Advanced Alternative Payment Models (APM), if participation is sufficient to meet certain thresholds.

The true value of the letter is found in its two attachments which contain information specific to you and your practice.

Medical Billing and Coding Services – MIPS Participation Attachments

Attachment A: Attachment A contains the eligibility/exemption status for the TIN and each individual provider enrolled under the TIN. This can be used to help you determine whether your group will be required to participate in MIPS for the performance year 2017 and if you should report as a group or as individual clinicians. NOTE: If your group chooses to report as a group, MIPS assessment will be based on ALL INDIVIDUALS in the group. This will not take into consideration any providers who would be individually exempt from participation.

Attachment B: Attachment B contains CMS’s best effort to answer some of the many questions you may have about the Quality Payment Program, its two tracks: MIPS and APM, and how you should prepare for participation.

If you find that your questions regarding MIPS are still left unanswered, or you would like some assistance in getting your practice prepared for MIPS performance year 2017, please give us a call or send an email at 205-329-7538 or jrtichie@codecollect.net

If you have not received your letter from CMS, you can also look up your MIPS eligibility on the QPP website at http://qpp.cms.gov/learn/eligibility

More information on MACRA, MIPS, and QPP can be found on our blog.

Or at http://qpp.cms.gov/

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