tci Medicare Compliance & Reimbursement - 2019 Issue 10

MACRA Coding Update: CMS Issues Update on MIPS Patient Relationship Codes

Hint: The modifiers won’t always be voluntary, CMS warns. Since MACRA mandated the Quality Payment Program (QPP), Medicare providers have been struggling to keep up with all the requirements, measures, and changes impacting their Part B reimbursement. And a recent CMS transmittal recommends practices prepare themselves for patient relationship coding changes down the pike, sooner rather than later. Context: Back in 2016, CMS unveiled its idea to use HCPCS Level II modifier codes to explain the patient-provider relationship in the Merit-Based Incentive Payment System (MIPS). The agency followed up with its traditional comment period and stakeholder tweaking. Finally...

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