HAP Radiology Billing and Coding Blog

Results of the Medicare Value Modifier Payment Adjustment for 2018

During 2016 we worked hard to provide our readers with information and advice that would allow them to maximize their performance under the Physician Quality Reporting System (PQRS) and therefore to maximize their reimbursement in 2018 under the associated Medicare Value-based Payment Modifier (VM).  The results have just been announced by the Centers for Medicare and Medicaid Services (CMS), and are available in a CMS Fact Sheet.

Categories: cms, value modifier, Quality Payment Program, QPP, quality measures

A Program for Successful PQRS Participation for Radiology Practices – Step 7

At Healthcare Administrative Partners, our mission is to educate practices on CMS Quality Programs and provide a path to optimized performance even in the most challenging markets. This is the final installment of our series of articles, “A Program for Successful PQRS Participation for Radiology Practices,” which was specifically designed to help you maximize reimbursement and reduce compliance issues under the Physician Quality Reporting System (PQRS).  So far we’ve covered...

Categories: radiology reimbursement, medicare reimbursement, value modifier, PQRS, MIPS, MACRA

Regulatory Changes Affecting Radiology and Radiation Oncology Reimbursement in 2016

A variety of federal legislative activities during 2014 and 2015 contained rulings that will begin to affect Medicare reimbursement to physicians next year. Most recently, The Centers for Medicare and Medicaid Services (CMS) issued its Medicare Physician Fee Schedule (MPFS) Final Rule for 2016 that will govern its payments to physicians.  The overall impact of the final MPFS changes to radiology and radiation oncology practices compared with the proposed changes issued earlier this year, is estimated by CMS as follows:

 

Categories: radiology reimbursement, radiation oncology reimbursement, MPFS, value modifier, PQRS, MIPS, MACRA

An Overview of the Medicare Quality Reporting Provisions Affecting Radiology Practice Reimbursements

The stage is set for a new era of Medicare payment modification using data self-reported by physicians that measures the quality of their work.  The two programs already in place are the Physician Quality Reporting System (PQRS) and the Value-Based Payment Modifier (VM).  These two will work in concert to determine either a positive, neutral or negative payment adjustment to the basic Medicare fee schedule, generally two years following the reporting year.  Note that the rewards and penalties for these programs are cumulative; failure to meet the PQRS reporting requirements will invoke a penalty under both the PQRS and the VM programs.

Categories: radiology reimbursement, value modifier, PQRS

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