MIPS Quality Measures for 2020 for PT, OT and SLP
For calendar year 2020, physical therapists, occupational therapists and speech-language pathologists will once again be considered Merit-Based Incentive Payment System (MIPS) eligible clinicians. In this article, I will answer some of the more frequent questions I receive about the MIPS program as they relate to the Quality Performance Measures.
Question #1
In Performance Period 2020, how many quality measures must physical therapists, occupational therapists and speech-language pathologists report?
Answer #1 The content here is for members only log in here or sign up. Question #2 How is the 70% data completeness calculated? Answer #2 The content here is for members only log in here or sign up. Question #3 In Performance Period 2020, how are quality measures scored? Answer #3 The content here is for members only log in here or sign up. Question #4 In Performance Year 2020, how many Quality Performance Measures are applicable to speech-language pathologists (SLPs)? Answer The content here is for members only log in here or sign up. Question #5 In Performance Year 2020, how many Quality Performance Measures are applicable to physical therapists (PTs) that can be reported via claims? Answer The content here is for members only log in here or sign up. Question #6 In Performance Year 2020, how many Quality Performance Measures are applicable to physical therapists (PTs) that can be reported via a registry? Answer The content here is for members only log in here or sign up. Question #7 In Performance Year 2020, how many Quality Performance Measures are applicable to occupational therapists (OTs) that can be reported via claims? Answer The content here is for members only log in here or sign up. Question #8 In Performance Year 2020, how many Quality Performance Measures are applicable to occupational therapists (OTs) that can be reported via a registry? Answer The content here is for members only log in here or sign up. Question #9 In Performance Year 2020, which Quality Measures applicable to physical therapy, occupational therapy and/or speech-language pathology therapy services are considered Outcome Measures? Answer #9 The following Quality Measures are considered Patient Reported Outcome Measures as well as High Priority Quality Measures: Measure 217: Functional Status Change for Patients with Knee Impairments Measure 218: Functional Status Change for Patients with Hip Impairments Measure 219: Functional Status Change for Patients with Lower Leg, Foot or Ankle Impairments Measure 220: Functional Status Change for Patients with Lumbar Spine Impairments Measure 221: Functional Status Change for Patients with Shoulder Impairments Measure 222: Functional Status Change for Patients with Elbow, Wrist or Hand Impairments Measure 478: Functional Status Change for Patients With Neck Impairments[/mepr-show]
Question #10 How can I access the specifications for each Quality Performance Measure that will tell me how often I have to report the Quality Measure, when do I have to report the Quality Measure, what must be documented in the medical record and which codes to report for each Quality Measure? Answer #10 The content here is for members only log in here or sign up. Question #11 What Quality Measures applicable to physical therapy, occupational therapy and/or speech-language pathology were deleted for Performance Year 2020? Answer #11 The content here is for members only log in here or sign up. Question #12 What is the difference between a Qualified Registry and a Qualified Clinical Data Registry (QCDR)? Answer #12 Per the Centers for Medicare and Medicaid Services (CMS), a QCDR is a CMS approved vendor that is in the business of improving health care quality. QCDR submission differs from qualified registry submission in that QCDRs can submit non-MIPS measures, called QCDR measures, as well as MIPS quality measures. They may also submit data for the Promoting Interoperability and Improvement Activities on behalf of the clinician(s). Click HERE to read more about the differences between a Quality Registry and a QCDR.[/mepr-show]
I hope you found the answers to the questions helpful and informative. Thank you for being a Gold Member!
All material posted on our website is the intellectual property of Gawenda Seminars & Consulting, Inc. and can’t be used, reproduced, or posted as your own material without the prior written approval of Gawenda Seminars & Consulting, Inc.
This article is not intended to and does not serve as legal advice or as consultative services, but is for general information purposes only.
Check Our Past Webinars!
Leave a Reply
Your email address will not be published. Required fields are marked *This site uses Akismet to reduce spam. Learn how your comment data is processed.
Since Measures #217-222 are all defined as change in status on the FOTO score, does that mean we cannot use other outcomes assessments like Care Connections?
You are correct.
These FOTO change in status measurements are the only REQUIRED measurements in the 6 total needed to be reported on, the other 5 can be a mix of the other ones available?
I do not understand your question.
Per answer #1 “6 quality measures, including one outcome measure”, FOTO measures are required as one out of the six?
PTs and OTs have many Quality Measures they can report in Calendar Year 2020. The FOTO measures are just some of the possible measures if reporting via a registry.
per answer #9 of what are considered outcome measures available to PTs, all of those per the CMS documents available on each outcome include a risk adjusted score of the PROM by FOTO. So, unless the patient is ineligible we are required to use FOTO measures to complete one of the required per answer #1 ” one outcome measure”?
I think you need more assistance understanding MIPS than I can give in this forum.
Can PTs use the Tobacco measure? It looks to be under the same category as the other PT applicable measures?
No
If a patient is less than 65 yo non-diabetic, therefore does not qualify for the diabetes, fall, dementia or maltreatment measures, do we ONLY report on the other 5 applicable? Functional outcome, functional status change, BMI, depression screen and medications.
If the patient does not meet the criteria for a particular measure, whether it’s age, CPT code, etc., then that measure is not applicable to that patient for that measure.
Rick:
A question about Specialty Measure Sets for PT:
We are a claimed based clinic and we where using measures 128,130,131, and 182. Clearly 131 is gone and when I called our EMR provider to upload 154 and 155 and take away one she said we didn’t need to as the other codes where within that specialty measure set so all we needed to do was to continue to report on just the three? Is that true?
thanks
They are not correct.
For a patient 65+ yo are we required to perform the #154/155 Fall Risk/POC and #181 Elder Maltreatment measures, or just eligible to perform those measures within the CPT/diagnosis ect. guidelines?
You need to look at each measure to see when that measure must be reported in Calendar Year 2020.
In the outpatient setting: If a patient has diabetes per a health history form, are we REQUIRED to perform one of the diabetes measures AND add a diabetes diagnosis code to their treatment case? or if we are not directly treating something related to their diabetes diagnosis, can we leave the diabetes measures alone?
You list Measure 181 Elder Maltreatment as a MIPS option for PTs for both claims based and registry reporting; however, none of the CPT codes listed as part of the denominator criteria contain are PT Eval or Re-Eval codes…just OT. How are PTs to report if we don’t meet the denominator criteria?
PT does meet the denominator criteria. Make sure you are looking at the 2020 MIPS Measures.