Coding and Reimbursement

Following the release of the 2020 Medicare Physician Fee Schedule Final Rule in early November, which includes the Quality Payment Program (QPP), ASCRS has updated its in-depth guides on the QPP. The QPP, created by MACRA, includes the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APMs). This exclusive, members-only benefit provides detailed explanations of the program tailored to ophthalmic practices.

Is your practice coding for maximum reimbursement and staying compliant on legal and regulatory issues? ASOA can help!

Developed in partnership with BSM Consulting and Arnold & Porter, these resources provide education on what you need to know:

If you are unable to view the video above, you can access it via Youtube here: https://youtu.be/_Rl2GXBwazw

The data submission period for the 2018 Merit-Based Incentive Payment System (MIPS) closed on April 2. If you submitted data through the Quality Payment Program (QPP) website, you can review your preliminary performance feedback data.

Please note, this does not include information on the Cost category. Additionally, between now and June 30, your score could change based on:

ASCRS•ASOA has updated the Medicare Participation Kit for 2019 to help members make decisions about their participation in Medicare. The kit provides details about Medicare in 2019, such as the 0.25% update factor, which was reduced from the MACRA-instituted 0.5% level as an offset for the Bipartisan Budget Act. In addition, the kit outlines the three options for Medicare participation: participating provider, non-participating provider, and private contracting.

ASCRS•ASOA members have exclusive access to a new overview guide of the 2019 QPP, which includes MIPS and Advanced Alternative Payment Models (APM) and impacts 2021 payments.

Recently, CMS updated the “Explore Measures” section of the Quality Payment Program website for the 2018 performance period. The website now includes 2018 Merit-based Incentive Payment System (MIPS) measures and activities for its four performance categories:

As we reported previously, CMS announced it had changed the name of the Advancing Care Information (ACI) category of MIPS to Promoting Interoperability.

Physicians have until March 31, 2018, to submit their 2017 MIPS performance data, which will impact 2019 payments. Physicians and groups may use the CMS QPP portal to report 2017 data for the Advancing Care Information (ACI) and Improvement Activities categories of MIPS. Quality data from EHR systems in QRDA III format may also be uploaded to the system.