Start Strong in 2020: Important Dates for Physician Practices

Originally published in the December 19, 2020 issue of MGMA’s Washington Connection
Reprinted with permission from MGMA

Transitioning to a new year means important federal program deadlines and launches. Below are key dates that executives should know as they prepare their medical practice for success in 2020.

DEC. 31

• Check MIPS 2019 eligibility by year’s end
  Clinicians are encouraged to confirm their 2019 Merit-based Incentive Payment System (MIPS) eligibility status by using the QPP Participation Status Tool to determine whether they must report data in 2020. The Centers for Medicare and Medicaid Services (CMS) recently concluded its second review of Part B claims and PECOS data spanning Oct. 1, 2018 through Sept. 30 of this year.
• Deadline to submit MIPS hardship and exception application
  Promoting Interoperability and Extreme and Uncontrollable Circumstances Exception applications for the MIPS 2019 performance year must be submitted by Dec. 31. MIPS participants in FEMA-designated disaster areas are automatically exempt from reporting and will have all four performance categories re-weighted to 0% of their final score.
• Deadline to review and dispute program year 2018 Open Payments data
  Visit the CMS Open Payments website to review data submitted from drug and device manufacturers describing any payments made to physicians in your practice. Clinicians have until the end of the year to dispute any incorrect information.

JAN. 1

• New 2020 Medicare payment rules and MIPS requirements
  The 2020 Physician Fee Schedule begins, which includes payment updates for Medicare services, changes to billing guidance for certain codes, and modifications to reporting requirements under MIPS. These details are outlined in MGMA’s member-exclusive analysis.
• Use of MBI on Medicare claims starts
  Starting Jan. 1, Medicare claims are required to contain the Medicare Beneficiary Identifier (MBI) in order to be processed. For patients who do not present with their new card, practices can get their MBI via your Medicare Administrative Contractor. Members can access the MGMA New Medicare Card Toolkit to prepare for the transition.
• AUC education and testing period begins
  Jan. 1 marks the start of the one year educational and operations testing period for the CMS Appropriate Use Criteria (AUC) program. Download the member-benefit AUC Toolkit to learn more.

JAN. 2

• MIPS 2019 data submission period starts
  2019 MIPS performance data can be submitted to CMS from Jan. 2 through March 31. Authorized representatives can submit clinician and practice data via the QPP webpage.

JAN. 22

• Close of Primary Care First and Kidney Care Choices application period
  Jan. 22 is the deadline to apply for the Primary Care First (PCF) Model and Kidney Care Choices (KCC) Model. PCF will be offered in 26 geographic regions starting in 2021, and the KCC Implementation Period will begin later in 2020. MGMA will share links to several informative resources prior to the deadline for practices seeking to understand whether these models are right for them.

Your Guide to 2020 Payment Rules & MIPS Requirements

Originally published in the November 20, 2019 issue of MGMA’s Washington Connection
Reprinted with permission from MGMA

It’s here! Your Guide to 2020 Payment Rules
& MIPS Requirements

DOWNLOAD MGMA’S MEMBER EXCLUSIVE ANALYSIS

The Centers for Medicare & Medicaid Services (CMS) released the final 2020 Physician Fee Schedule (PFS), which includes payment updates for Medicare services, changes to billing guidance for certain codes, and modifications to reporting requirements under the Merit-based Incentive Payment System (MIPS).

MGMA Government Affairs reviewed, analyzed, and distilled this nearly 2,500-page final rule in a member-benefit analysis. The resource breaks down significant payment and quality reporting changes for 2020 and offers practical takeaways for busy medical group practice executives. Key regulatory provisions include:

• The CY 2020 PFS conversion factor remains relatively flat at $36.0896. The CY 2020 national average anesthesia conversion factor will be $22.2016.
• In 2021, CMS will maintain separate payment rates for E/M office visits, delete level 1 office visits for new patients, and increase the payment rate for E/M services.
• Payment rates for transitional care management services will increase in CY 2020.
• The MIPS score to avoid a negative payment adjustment in 2022 will increase to 45 points based on performance in 2020.

MGMA will provide further education on this complex regulation during our 2020 Medicare Payment Outlook member-benefit webinar on Thursday, Dec. 5 at 1 pm ET. Register now to join us and learn more about how your organization can prepare for these new policies in 2020.