HAP Radiology Billing and Coding Blog

Update on The Quality Payment Program on March 17, 2021

The Quality Payment Program (QPP) continues to be modified due to the COVID-19 public health emergency. The Centers for Medicare and Medicaid Services (CMS) recently announced some leeway for clinicians affected by the pandemic in 2020 and 2021.

Categories: radiology reimbursement, cms, QPP, COVID-19

Major Cut in Radiology Reimbursement For 2021 Is Finalized By CMS on December 7, 2020

The Centers for Medicare and Medicaid Services (CMS) has released the final set of rules that will govern the Medicare payment system for the coming year, thereby affirming the drastic cut in radiology reimbursement for 2021 that was proposed earlier this year.  There were few surprises in the Medicare Physician Fee Schedule (MPFS) Final Rule that were not contained in the proposed rule, other than a slight improvement in the fee schedule conversion factor and a change to the QPP Performance Threshold.

Categories: radiology reimbursement, cms, MPFS, radiology, QPP

Get Feedback on Your 2019 Quality Payment Program Performance on September 22, 2020

Quality Payment Program (QPP) participants can now obtain information about whether their practice will receive a positive, negative, or neutral Medicare fee schedule adjustment in 2021 based on the 2019 data they submitted. The Centers for Medicare and Medicaid Services (CMS) announced that clinicians who participated in the Merit-based Incentive Payment System (MIPS) in 2019 can access their performance feedback by logging in to the Quality Payment Program website

Categories: radiology reimbursement, physician reimbursement, cms, Quality Payment Program, QPP, quality measures

Quality Payment Program Modified Due to COVID-19 Outbreak on March 24, 2020

The Centers for Medicare and Medicaid Services (CMS) announced that they have adjusted certain aspects of the Quality Payment Program (QPP) in response the Public Health Emergency (PHE) caused by the COVID-19 coronavirus outbreak.  CMS has extended the deadline for reporting 2019 Merit-based Incentive Payment System (MIPS) data and has relaxed the criteria for avoiding a penalty in 2021 based on submission of 2019 data.

Categories: cms, MIPS, Quality Payment Program, MIPS participation, QPP

Quality Payment Program Update for 2020 on March 2, 2020

Participation in the Quality Payment Program (QPP) means that you always have several years’ information in play at one time.  The score you earned from submitting 2018 data will now be impacting your Medicare reimbursement in 2020; you have just completed your 2019 performance and it’s time to submit your data; and finally, you now have to begin your 2020 performance year.

Categories: cms, MIPS, Quality Payment Program, MIPS participation, QPP, quality measures

How the Medicare Final Rule For 2020 Will Affect Radiologists on November 15, 2019

The Centers for Medicare and Medicaid Services (CMS) has released the annual changes to the Medicare Physician Fee Schedule (MPFS) in its Final Rule that contains not only adjustments to Medicare reimbursement but also revisions to the Quality Payment Program (QPP) for 2020 and beyond.   The MPFS Final Rule does not contain very many significant changes for the coming year, especially for radiology, but one of its provisions will have a far-reaching effect on radiology beginning in 2021. 

Categories: medicare, medicare reimbursement, cms, MPFS, radiology, QPP, quality measures

Get Feedback on Your 2018 Quality Payment Program Performance on August 23, 2019

The Centers for Medicare and Medicaid Services (CMS) announced that clinicians who participated in the Merit-based Incentive Payment System (MIPS) in 2018 can access their 2018 performance feedback by logging in to the Quality Payment Program website.   The information should confirm whether you or your practice will receive a positive, negative, or neutral Medicare fee schedule adjustment in 2020 based on the 2018 results.  According to a posting on the CMS website, 98% of eligible clinicians participated in MIPS for 2018, up from 95% in 2017, and 97% will receive a positive payment adjustment by virtue of exceeding the 15-point performance threshold. 

Categories: cms, MIPS, Quality Payment Program, MIPS participation, QPP

First Look at the New Medicare Rules for 2020 on August 13, 2019

The Centers for Medicare and Medicaid Services (CMS) released their annual proposal for changes to the Medicare payment system for the coming year, and they also released new information about the existing mandate for the use of Clinical Decision Support (CDS) beginning in 2020.  The Medicare Physician Fee Schedule (MPFS) Proposed Rule contains not only proposed adjustments to Medicare reimbursement but also proposed changes to the Quality Payment Program (QPP) for 2020 and beyond.

Categories: medicare, medicare reimbursement, MPFS, Quality Payment Program, radiology, QPP

Update on MIPS Reporting and Payment Adjustments for Radiology on March 25, 2019

The year 2019 marks the third reporting period under the Medicare Incentive-based Payment System (MIPS).  Radiology groups’ performance this year will determine their positive or negative Medicare fee schedule adjustment for payments in 2021, just as this year’s Medicare payment adjustment was determined by performance in 2017.

Categories: cms, MIPS, Quality Payment Program, MIPS participation, QPP

Review of The Medicare Quality Payment Program for 2019 on November 19, 2018

With the publication of the Medicare Physician Fee Schedule (MPFS) Final Rule for 2019, which includes the Quality Payment Program (QPP) Final Rule, we can now review how radiologists can prepare to maximize their 2021 Medicare reimbursement through QPP participation in 2019.  The QPP includes both the Medicare Incentive-based Payment System (MIPS) and Alternative Payment Model (APM) tracks.  Since most radiology groups are currently participating in MIPS, we will focus on steps to take for successful participation in this program.

Categories: MPFS, MIPS, Quality Payment Program, radiology, QPP, APM

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