decisionhealth Newsletters, Part B News - 2015 Issue 8 (August)
NPPs exempt from value modifier will count when CMS tallies group data
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Article Overview
This article explains CMS clarification from an open door call regarding proposed Medicare physician fee schedule quality reporting requirements. It focuses on how groups are counted for value-based payment calculations, how exempt non-physician practitioner groups are treated, and how these policies relate to PQRS and group reporting. The piece is aimed at practices, coders, and compliance staff who track Medicare quality reporting and payment adjustment exposure.
Why This Topic Matters
Understanding which practitioners are counted in a group and which payment adjustments may apply helps practices assess reporting obligations and avoid unexpected Medicare payment impacts.
What You Will Learn
- How CMS described group counting for value-based payment purposes
- Which categories of practitioners were discussed in relation to exemption status
- How group reporting and individual quality reporting were distinguished
- What Medicare quality reporting topics were addressed in the CMS clarification
Who Should Read This
- Medical coders
- Practice managers
- Compliance staff
- Billing staff
- Healthcare administrators
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