MIPS Questions and Answers: Part 2
The Merit-Based Incentive Payment System (MIPS) in 2019 will now include physical therapists, occupational therapists and speech-language pathologists that treat Medicare beneficiaries in the private practice setting. The simplest way to know if you are a private practice under the Medicare program is that you submit claims to your Medicare Administrative Contractor on a 1500-claim form. Over the next several weeks, I will be answering question I receive on the MIPS program to help you get prepared. In addition, I will be presenting a 2.5 hour MIPS webinar on December 18, 2018 from 1:00pm – 3:30pm ET. For additional information on this webinar and to register, click HERE.
If you missed last weeks article “MIPS Questions and Answers: Part 1” click HERE.
Question
How can I participate in the MIPS program in 2019?
Answer
The content here is for members only log in here or sign up.
Question
For MIPS reporting in 2019, how is an individual defined?
Answer
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Question
For MIPS reporting in 2019, how is a group defined?
Answer
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Question
For MIPS reporting in 2019, how is a virtual group defined?
Answer
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Question
What are the 4 performance categories in the MIPS program?
Answer
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Question
In 2019, how can physical therapists, occupational therapists and speech-language pathologists report quality measures to CMS?
Answer
The content here is for members only log in here or sign up.
Question
In 2019, how many quality measures must physical therapists, occupational therapists and speech-language pathologists report?
Answer
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Question
How is the 60% completeness defined?
Answer
The content here is for members only log in here or sign up.
I Hope you enjoyed MIPS FAQs Part 2. Thank you for being a Gold Member!
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Will hospital based outpatient facilities be included in the MIPS program?
MIPS is for settings that submit claims on a 1500 claim form.
Thanks!
For practices that bill incident-to and are reporting as a group with physicians, does the practice choose which measures they want to participate in and all clinicians (physicians and therapists) will receive the same adjustment. For example, if the physicians are already reporting, is it necessary to complete the therapy measures if they are all under the same TIN?
If you think the physicians can meet the minimum threshold without the PTs, you could take that chance.
All of our providers are below the low volume threshold as individuals, but obviously as a group, we are above. Based on everything I’ve been reading and trying to understand re: MIPS required reporting, it looks like the only providers REQUIRED to report are individuals who exceed all three low volume thresholds. Groups are eligible to participate, either on an opt-in or voluntary basis. Is this correct? I am already enrolled in your webinar for the 18th, but I’m trying to get as much info as I can.
You are correct in your statement.
Thanks for answering my question the other day. I am signed up for your MIPS course coming next week but I was wondering how do we sign up for MIPS on a volunteer basis. We are a clinic but will be doing per provider not group
The opt-in instructions have not yet been released by CMS.
I would pay attention.
In regards to 60% completeness, we are required to report on 6 quality measures for ALL payer types (work comp, BCBS, Aetna, etc including Medicare) if using a quailified registry or a QCDR?
Yes!
you mention a group is 2+ clinician under one tax id. if you opt in do both therapist automatically get opted in? what if only one wants to participate?
thanks
If you only have 2 PTs and only 1 wants to opt-in, it would then not be a group since you are only opting-in one PT. They would opt-in as an individual.