March 8, 2017

Lookout for MACRA and Don’t Get MIPS in the Butt

By admin

MACRA (Medicare Access and CHIP Reauthorization Act of 2015) was the largest change in how Medicare clinicians were paid.
MIPS is a sister program, the “Merit-Based Incentive Payment System” – and both are scheduled to take effect in 2017.
MIPS applies to Medicare Part B clinicians, including behavioral health/psychiatry physicians, physician assistants, nurse practitioners, clinical nurse specialists, and certified registered nurse anesthetists.
MIPS isn’t for everyone: Psychiatrists are exempt from MIPS reporting and payment adjustments for a particular year if:
• It is their first year of Medicare enrollment
• They meet the “low volume threshold” of no more than $10,000 in Medicare billings and 100 Medicare patients
• They qualify for the MACRA bonus for “advanced” alternative payment models (APMs)
• They meet the definition of a partial qualifying APM participant and choose not to report under MIP.
MIPS may apply to clinical psychologists and clinical social workers starting with reporting in 2019 and payments in 2021.

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