Next Event: NCCI Edits & Modifier 59: Version 31.2
Date: June 26,2025
MIPS 2019: Must I Report as a Group
Effective January 1, 2019, physical therapists, occupational therapists and speech-language pathologists in private practice (submit claims on a 1500 claim form) are able to participate in the Merit-Based Incentive Payment System (MIPS) for Performance Year 2019. If an individual therapist exceeds all 3 of the low-volume thresholds during both determination periods, they will be required to participate in MIPS in 2019. But what if as an individual, not one therapist in a practice exceeds all 3 of the low-volume thresholds during both determination periods, but the group does. Must the group then participate in MIPS in 2019? The answer is
MIPS Questions and Answers: Part 4
Question How does CMS calculates the penalty for those choosing not to participate/report? Answer Question Regarding the Improvement Activities, how can we determine which Improvement Activities are considered high-weighted and which are considered medium-weighted? Answer Question How do we go about opting in and when is the deadline? Answer Question If we have 11 therapists and 7 physicians but all therapy billing is incident to the physician, are we classified as a small practice since we only have 7 physicians? Answer Question If we are excluded from MIPS, do not want to opt-in to MIPS and we submit via claims, is