E/M Coding Alert - 2019 Issue 11
MIPS: See What’s New With MIPS Performance Thresholds and More
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Article Overview
This article explains proposed updates to the Medicare Quality Payment Program for MIPS and highlights how the 2020 rule could affect physician reimbursement across specialties. It is aimed at clinicians, practice leaders, and coding or compliance professionals who need a high-level understanding of performance thresholds, penalty limits, category reweighting, improvement activities participation, and score trend analysis discussed in the proposal.
Why This Topic Matters
The proposed changes could materially affect future payment adjustments and practice performance planning under MIPS. Understanding the scope of the updates helps practices anticipate reporting priorities and reimbursement risk.
Article Sections
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See What’s on the MIPS 2020 Proposal Agenda
Introduces the main themes in the proposed rule and frames the areas of MIPS policy being revised for upcoming performance years.
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1. Performance threshold
Discusses projected changes to the MIPS threshold framework and the related exceptional performance benchmark across several performance years.
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2. Penalty increase
Summarizes the proposed change to the maximum negative payment adjustment under the program.
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3. Category reweighting
Covers proposed shifts in category weighting and how those changes may affect the balance among MIPS performance categories.
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4. Improvement Activities
Describes proposed participation expectations for improvement activities within group reporting.
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5. MIPS Final Score analysis
Reviews the article’s discussion of score trends across performance years and the general explanation offered for score changes.
What You Will Learn
- The main elements of the proposed MIPS policy updates for upcoming performance years.
- How the article frames changes to threshold, penalty, and scoring trends.
- Which MIPS performance categories are being rebalanced in the proposal.
- What types of program participation expectations are being emphasized for groups and clinicians.
Who Should Read This
- Physicians
- Practice administrators
- Coding and compliance professionals
- Revenue cycle staff
- Quality reporting teams
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