On November 1, the Centers for Medicare & Medicaid Services (CMS) released its 2,378-page final rule updating payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2019. The rule also includes updated payment and policy changes to the Medicare Access and CHIP Reauthorization Act (MACRA) Quality Payment Program (QPP) starting January 1, 2019. The rule follows the release of the proposed rule in July and the subsequent close of the public comment period in early September.
This final rule includes critical changes to the QPP and Medicare’s physician billing and payment system that will take effect January 1, 2019. Some of the highlights include:
- Finalization of the 2015 Edition certified EHR technology requirement for the 2019 performance period Merit-based Incentive Payment System (MIPS) Promoting Interoperability performance period
- Expanding the definition of a MIPS-eligible clinician to include physical therapists, occupational therapists, speech-language pathologists, audiologists, clinical psychologists, and registered dietitians
- Moving clinicians to a smaller set of objectives and measures with new performance-based scoring method for the MIPS Promoting Interoperability category
- Updating the Advanced APM and Other Payer Advanced APM Certified EHR Technology (CEHRT) threshold requiring at least 75% of eligible clinicians use CEHRT
- Payment for the first time for technology-based services such as telehealth visits
- Sweeping E&M coding changes (implementation delayed until 2021)
Our Health Reform Simplified team provide a high-level overview of the 2019 final rule during the live webinar on November 15 at 4:00 p.m. (ET). Register today.