MIPS Questions and Answers: Part 3
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 tomorrow, December 18, 2018 from 1:00pm – 3:30pm ET. For additional information on this webinar and to register, click HERE.
If you missed “MIPS Questions and Answers: Part 2” click HERE
If you missed “MIPS Questions and Answers: Part 1” click HERE.
Question
In 2019, what outcome measures are available to physical and occupational therapists?
Answer
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Question
In 2019, what high priority measures are available to physical and occupational therapists?
Answer
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Question
In 2019, how can you submit quality measures to the Centers for Medicare and Medicaid Services?
Answer
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Question
In 2019, how are quality measures scored?
Answer
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Question
What is a topped out measure?
Answer
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Question
What is the minimum score I need to achieve in 2019 to avoid a negative payment adjustment in 2021?
Answer
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I hope you enjoyed MIPS FAQs Part 3. Thank you for being a Gold Member!
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Thanks Rick! Question for you. Around the question you answer regarding submission of quality measures to CMS, you state that “not all options are available to individuals, small groups or large groups” Can you point me to where I can find our options? Also, can you comment on how “improvement activities” will be submitted? … that maybe in Part 4. Plan to register for the 18th but I will have to do the playback. Bummer! Thanks again.
Your questions were addressed in our December 18, 2018 webinar and I will continue to post FAQs on MIPS on our website.
For measure 130, what if a patient provides a list of medications but does not recall the dosage. If I recall correctly, for PQRS there was a code that indicated the patient had provided meds, but it wasnt complete. I dont see that for Medication quality measure currently. Thanks
Please read the 130 Measure for medications. Under instructions, it states “This measure is to be submitted at each denominator eligible visit during the 12 month performance period. Eligible clinicians meet the intent of this measure by making their best effort to document a current, complete and accurate
medication list during each encounter”. Under definition, it states “Current Medications – Medications the patient is presently taking including all prescriptions, over-the counters, herbals and vitamin/mineral/dietary (nutritional) supplements with each medication’s name, dosage,
frequency and administered route.”
I am seeing differing opinions of what measures are included pee CMS; the documentation company I use is Casamba Therapy Source. They are saying Medicare is only giving the option of reporting on BMI, Meds, Pain, an outcome assessment and men the FOTO measures 217-223. It is saying falls, falls poc, and diabetic foot screening is recommended by APTA, AOTA, and ASHA but not mandated by CMS. Any clarification on this?
I assume they are talking about the PT & OT Specialty set. In that set are just Measures 128, 130, 131, 182 and the FOTO Measures.
Hey Rick as the new year starts we were going to have all the new Medicare PT evals start with MIPS. The Medicare patients that are continuing into the new year is it ok to wait until they reach the 10 visit / 30 days until we place on MIPS?
Quality measures in the MIPS program are due when certain CPT codes are billed on the visit. You will need to look at each measure to see when they are required to be reported.
Thank you!!