decisionhealth Newsletters, Coder Pink Sheets - 2019 Issue 6 (June)
MIPS update: Try out patient relationship modifiers to prepare for when they’re mandatory
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Article Overview
This article covers CMS guidance on the patient relationship category modifiers introduced in the Medicare physician fee schedule and how they relate to the Cost component of MIPS. It is useful for clinicians, coders, and revenue cycle staff who want to understand the current voluntary status of the modifiers, the expectation of future mandatory reporting, and the broad categories CMS uses to frame patient relationships. The article also points readers to CMS transmittal and supplemental guidance resources.
Why This Topic Matters
The article matters because it highlights a Medicare reporting change that practices may need to prepare for in order to support accurate MIPS-related claims processing and compliance workflows.
Article Sections
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CMS guidance on patient relationship category modifiers
Overview of the Medicare policy context, including the status of the patient relationship modifiers and their connection to MIPS reporting. The section also references CMS communications and implementation guidance.
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Patient relationship categories
General discussion of the modifier categories and the types of clinician-patient relationships they are intended to represent. The section frames the categories at a high level without detailed coding instruction.
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Resources
Links to CMS transmittal and supplementary educational materials related to the topic.
What You Will Learn
- How CMS is positioning patient relationship category modifiers within Medicare reporting
- Why the modifiers are relevant to MIPS-related workflows
- What broad types of patient relationship categories CMS is describing
- Where to find related CMS guidance and supplemental resources
Who Should Read This
- Physicians
- Clinicians
- Medical coders
- Billing staff
- Revenue cycle staff
- Practice administrators
Modifiers Discussed
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