Regulatory Alert: CMS Finalizes 2020 Payment and Quality Reporting Changes

Originally published in the November 1, 2019 issue of MGMA’s Washington Connection
Reprinted with permission by MGMA

Today, the Centers for Medicare & Medicaid Services (CMS) released the final 2020 Physician Fee Schedule (PFS), which includes payment updates and modifications to the Merit-based Incentive Payment System (MIPS) reporting requirements and alternative payment model (APM) participation options starting Jan. 1, 2020. The final rule:

  • Sets the CY 2020 PFS conversion factor at $36.0896. The CY 2020 national average anesthesia conversion factor will be $22.2016.
  • Deletes level 1 office visits for new patients and maintains separate payment rates for E/M office visits starting in 2021.
  • Outlines changes to MIPS reporting requirements, including increasing the performance threshold to avoid a payment penalty in CY 2022 based on CY 2020 performance.
  • Increases the MIPS payment adjustment to +/- 9%.
  • Maintains the (up to) 10% exceptional performance bonus and current MIPS performance category weights from the 2019 performance period.

For more information, review the physician payment fact sheet and QPP fact sheet associated with the 2020 final PFS. MGMA will analyze the final rule and provide a detailed analysis as a member benefit. Contact MGMA government affairs with questions by emailing govaff@mgma.org or calling 202.293.3450, 877.275.6462 toll-free.

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