Medical Billing Blog

Stay up to date with the latest revenue cycle news, trends, and policies.

Blog Posts Relating to:

Value-Based Care



MIPS Participation Guide for 2018

October 16, 2018

 

The purpose of this post is to walk you everything you need to know in order to successfully participate in MIPS for the 2018 performance year. Whether you’re relatively fluent in MIPS or a complete beginner, we hope you’ll leave with a general understanding of the MIPS system and what’s required of you.

If you’re completely new to MIPS, check out the following links before reading the remainder of this article.

  1. Our MIPS Page: Contains a general explanation of MIPS, along with information about who must participate in 2018, the evaluation criteria (Performance Categories), and Reporting Options for providers
  2. MIPS 2018 Overview and Assistance: A blog post containing information about MIPS 2018 eligibility, exemptions, and logistics

Continue reading…



MIPS 2018 Overview and Assistance

May 31, 2018

 
In previous posts, we have discussed the MIPS Eligibility Online Lookup Tool, where providers can enter their NPI numbers and find out their MIPS eligibility status. Well, the CMS has officially released a new version for 2018. With it, providers can discover their participation status for the MIPS 2018 performance year, and therefore determine whether or not they are eligible for financial incentives/penalties in 2020. Click the button below to utilize this tool

Reminder – The CMS has raised the eligibility threshold for 2018 to providers who:

  • accumulate $90,000 in Medicare Part B allowed charges

AND

  • provide covered professional services to 200 Medicare Part B-enrolled beneficiaries

Continue reading…



Medicare Updates for the New Year: 2018 Fee Schedule, MIPS, and More

January 6, 2018

 


2018 Medicare Physician Fee Schedule
In November, the Centers for Medicare and Medicaid Services (CMS) finalized the 2018 Physician Fee Schedule. The most broadly relevant change is that to the payment Conversion Factor. The CMS has increased the payment rate by 0.41%. This change is the result of “the 0.5% update established under the Medicare Access and Chip Reauthorization Act (MACRA) of 2015, which has been reduced by 0.09% due to the misvalued code target recapture amount, required under the Achieving a Better Life Experience (ABLE) Act of 2014″.

Continue reading…



Should I participate in the Quality Payment Program and MIPS?

May 15, 2017

The following information is provided by the Centers for Medicare & Medicaid Services:


You may have heard that the Centers for Medicare & Medicaid Services (CMS) is reviewing claims and letting practices know which clinicians should take part in the Merit-based Incentive Payment System (MIPS). MIPS is an important part of the new Quality Payment Program.

The Quality Payment Program works to make Medicare better by keeping patients at the center of healthcare while paying clinicians based on their performance. It replaces the Sustainable Growth Rate formula, which threatened clinicians participating in Medicare with potential payment cuts for 13 years. This program combines and streamlines many existing Medicare quality programs. It also gives new ways to improve care delivery by supporting and rewarding clinicians who:

  • Find new ways to engage patients, families, and caregivers.
  • Improve care coordination and population health management.

Continue reading…



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