Payments > Insurance Payments
Tell me more about MIPS?
johnpaul4691:
Tell me more about MIPS?
johncogger:
Eligible clinicians will be evaluated based on 4 categories:
❂ Quality- based on the existing PQRS system
❂ Resource use: based on the Value based payment modifier model
❂ Advancing Care Information: which is similar to MU mandates
❂ Clinical practice improvement categories
Read more: https://goo.gl/DHRDIU
Michele:
This is the new method Medicare is using to determine the amount providers will be paid. Providers will be assigned a composite score based on the four areas listed in the previous post and their reimbursement will be dependent on that score. It doesn't start until 2019 but it will be based on claim information from 2017 (only one month away).
Christy:
ok, so for a LCSW who did not report PQRS in 2015:
This year she has a 2% fee reduction.
She sees only a handful of Medicare patients and definitely bills under $10,000 a year.
So is she MIPS exempt? And if so, going forward how will her fee schedule be determined?
Michele:
At this time mental health providers are exempt from MIPS until 2019 reporting year. According to the Final Rule:
In 2017 MIPS applies to Clinicians who bill Medicare Part B using the physician fee schedule, including:
•Physicians (including psychiatrists)
•Physician assistants
•Nurse practitioners
•Clinical nurse specialists
•Certified registered nurse anesthetists
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