Merit-Based Incentive Payment System
- 2020 Reporting Exemptions Due to COVID-19: CMS is granting hardship exemptions to Merit-Based Incentive Payment System (MIPS) reporting requirements on a case-by-case basis due to COVID-19. It is therefore possible for a clinician or group to request exemption from all four performance categories in 2020 (see Table 2). If clinicians submit a hardship exception application for all four MIPS performance categories and their application is approved, they will be held harmless from a payment adjustment in 2022—meaning they will not be eligible for a bonus and not face potential penalties based on their MIPS performance in 2020.
- Performance Threshold: CMS proposes to set the performance threshold that clinicians need to achieve to avoid a penalty in 2021 at 50 points, down from 60 points, which had been floated previously.
- MIPS Value Pathways (MVPs): CMS is committed to developing MVPs, which would combine all four categories of MIPS reporting into a single, more harmonized process. However, due to COVID-19, the implementation of MVPS is being delayed until 2022. ACEP is working with CMS on developing an MVP for emergency medicine and is examining how ACEP’s qualified clinical data registry, the Clinical Emergency Data Registry (CEDR), can help emergency physicians participate in an MVP.
Additional information on MIPS is available here.
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ACEP Now: Vol 39 – No 09 – September 2020Other Resources
Resources for these and other topics can be found on the reimbursement section of the ACEP website. ACEP Director of Reimbursement David McKenzie, CAE, is also available to field your questions at 800-708-1822, ext. 3233. Finally, ACEP offers well-attended and highly recommended coding and reimbursement educational conferences annually. Visit www.acep.org/rc for more information.
Dr. Granovsky is president of LogixHealth, an ED coding and billing company, and currently serves as the course director of ACEP’s Coding and Reimbursement courses. He may be reached at mgranovsky@logixhealth.com.
Mr. McKenzie is ACEP director of reimbursement.
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