2023 MIPS Quality Measure Changes

Every new MIPS year brings changes to the list of available quality measures. Below is a list of all MIPS quality measures that were added, deleted, or changed for the 2023 performance year in the 2023 Final Rule. Click the link in the measure title to see the final rule description for new, changed, or deleted measures (tip: skip directly to the section titled “Rationale” for a summary of the measure changes and why they are being made).   9 New Quality Measures - As part of scoring changes made in the 2022 final rule, these 9 measures will have [...]

By |2022-11-23T17:23:18-05:00November 21st, 2022|Medicare Quality Payment Program (APMs/MIPS), MIPS|

Understanding MIPS Payment Adjustments

The 2021 final MIPS performance feedback was released last week, along with the corresponding payment adjustment information. If you are a MIPS-eligible clinician and have not reviewed your feedback yet, make sure to do so before October 21. October 21 is the deadline to submit a targeted review request if you believe anything in your results is incorrect. Check your eligibility here (no login required, just enter an NPI): https://qpp.cms.gov/participation-lookup Check your performance feedback by logging in here (HARP account required): https://qpp.cms.gov/ (New QPP portal users, check out my article here about how to create a HARP account and get [...]

By |2023-01-23T12:02:07-05:00August 30th, 2022|Medicare Quality Payment Program (APMs/MIPS), MIPS|

Finding & Verifying MIPS Payment Adjustments – RAs and Reason Codes

MIPS Performance Feedback reports are released in the summer each year and show a provider or practice what payment adjustment to expect for the coming year. Once payments start to be processed for applicable dates of service, many providers want to confirm how these amounts are being applied, and may want to report on or track these payments throughout the year. There are three codes to look for on a Remittance Advice (RA) that indicate MIPS payment adjustments: CO-144 indicates a positive payment adjustment: The glossary shows "CO: Contractual obligations. The patient may not be billed for this amount." and [...]

By |2022-12-10T18:17:23-05:00July 22nd, 2022|Medicare Quality Payment Program (APMs/MIPS), MIPS|

New to MIPS or QPP? Access Detailed Eligibility and Feedback on qpp.cms.gov

One of the first steps in understanding your or your organization's requirements and participation in the Quality Payment Program is to connect to your organization through the QPP portal at qpp.cms.gov. This allows you to see significantly more information than is available through the public-facing eligibility tool - information which is critical to making an educated decision about if or how to participate in MIPS. At a high level, this requires two steps: creating a HARP account, and connecting to your practice on qpp.cms.gov. The process outlined below may seem long, but it only has to be completed once to [...]

By |2022-12-10T17:50:59-05:00January 17th, 2022|Medicare Quality Payment Program (APMs/MIPS), MIPS|

Tracking the Legal Challenges and Changing Deadlines for the COVID Vaccine Mandates

In early November, two sweeping COVID vaccine mandates were added to the existing government contractor vaccine mandate. For a summary of these rules and who was initially covered under each, reference the earlier article here. In the months since, there have been multiple legal challenges and rulings that have affected all three mandates. We'll continue to update the list of changes below as the court cases progress. 1. Government Contractor Mandate: 11/30/2021: the government contractor mandate was paused in three states: KY, OH, and TN. [Source] 12/7/2021: the government contractor mandate was paused nationwide. [Source] 2. CMS Mandate: 11/29/2021: the [...]

By |2022-11-29T09:13:09-05:00December 29th, 2021|COVID-19, Government Mandates|

2022 MIPS Improvement Activity Changes

The list of 2022 Improvement Activities has not been posted to the QPP Resource Library yet, but for those wanting to plan ahead and complete their Improvement Activity or Activities in the first 90 days of 2022, below are the changes to 2022 MIPS Improvement Activities from the Final Rule. Until the 2022 list is posted, reference the 2021 descriptions and required documentation in the data validation criteria available for download here, and compare it to the 2022 changes from the final rule below. For new and revised activities, click the link in the activity name to see the description [...]

By |2022-11-29T09:14:26-05:00December 6th, 2021|Medicare Quality Payment Program (APMs/MIPS), MIPS|

2022 MIPS Quality Measure Changes

Every new MIPS year brings changes to the list of available quality measures. Below is a list of all MIPS quality measures that were added, deleted, or changed for the 2022 performance year in the Final Rule. Click the link in the measure title to see the final rule description for new or changed measures (tip: skip to the section titled "Rationale" for a summary of the measure changes and why they are being made).   New Quality Measures - Also new for 2022 scoring, these measures will have a 7-point minimum score in their first year (2022) and a [...]

By |2022-11-29T09:15:02-05:00November 24th, 2021|Medicare Quality Payment Program (APMs/MIPS), MIPS|

COVID-19 Vaccines for Healthcare Workers: Who is Required to Get Vaccinated? (And Who Still Isn’t?)

UPDATE: The information below was accurate as of 11/4/2021, when it was published, but as legal challenges to these mandates continue, the changing enforcement jurisdictions and deadlines will be updated in the article here.   Two more rules came out today from the Biden administration regarding COVID-19 vaccination. The first covers healthcare workers at facilities that are certified by Medicare or Medicaid under specific health and safety regulations (Conditions of Participation (CoPs), Conditions for Coverage (CfCs), or Requirements). Notably, this does NOT include physician offices, as they are not subject to these regulations. The second rule came from the Occupational [...]

By |2022-11-29T09:15:51-05:00November 4th, 2021|COVID-19, Government Mandates|

Big Scoring Changes for 2022 MIPS

The final rule for the 2022 MIPS program was released yesterday, and it contains major changes to how MIPS will be scored next year. Providers who have been avoiding the payment cut by simply submitting whatever data their EHR happens to capture may find this is no longer sufficient, and providers who have been earning 100% scores and the maximum upward payment adjustment every year may find this is no longer attainable. Providers without an EHR can still avoid the cut and even earn an upward adjustment, but this becomes even more difficult in 2022. However, some additional policies have [...]

By |2022-11-29T09:16:25-05:00November 3rd, 2021|Medicare Quality Payment Program (APMs/MIPS), MIPS|

October 1, 2021 ICD-10 Changes

Every year, CMS publishes updates to the ICD-10 code set for discharges and encounters that take place on or after October 1. For the 2022 ICD-10 code set (effective October 1, 2021), there are 159 new billable codes, most of which add detail to existing, less-specific codes. In addition, there are some new non-billable codes, deletions, and changes to code descriptions. While many of the code changes will only affect a few specialties or subspecialties, several changes will affect a broader group of providers […]

By |2022-11-29T09:17:02-05:00September 20th, 2021|Billing and Coding, CMS|
Go to Top