The Centers for Medicare & Medicaid Services (CMS) is reviewing claims and letting practices know which clinicians need to take part in MIPS, the Merit-based Incentive Payment System, part of the new Quality Payment Program.
In late April through May, practices will get a letter from the Medicare Administrative Contractor (MAC) that processes Medicare Part B claims. This letter will tell the participation status of each MIPS clinician associated with the Taxpayer Identification Number (TIN) in a practice.
CMS says that clinicians should participate in MIPS for the 2017 transition year if they bill more than $30,000 in Medicare Part B allowed charges a year and provide care for more than 100 Part B-enrolled Medicare beneficiaries a year.
The Quality Payment Program intends to shift reimbursement from the volume of services provided toward a payment system that rewards clinicians for their overall work in delivering the best care for patients. The program replaces the Sustainable Growth Rate formula and streamlines the “Legacy Programs” Physician Quality Reporting System (PQRS), the Value-based Payment Modifier (VM) and the Medicare Electronic Health Records (EHR) Incentive Program.
CMS says it committed to diligently working with providers during this first year of the program to streamline the process as much as possible.