CMS Proposes Changes to MIPS for the 2020 Reporting Year
In January 2019, #PTTRANSFORMS published answers to some common MIPS questions. The Centers for Medicare and Medicaid Services (CMS) recently released its proposed Physician Fee Schedule for 2020, which includes 4 major changes to MIPS that are relevant to physical therapists (PTs).
1. Increase in the Minimum Number of MIPS Points for a Neutral Payment Adjustment
Under MIPS, providers earn points for Quality Performance Measures and Improvement Activities—2 required categories for PTs. In addition, submitting MIPS data via a qualified clinical data registry, such as APTA's Physical Therapy Outcomes Registry, could earn practice points in the Promoting Interoperability category.
In 2019, to receive a neutral payment adjustment, a provider must earn 30 points. Under the CMS proposed rule that number would increase to 45 in the 2020 reporting year.
2. New Measures for Physical and Occupational Therapy
CMS is proposing to add several new measures to the physical therapy and occupational therapy set of measures. These include:
- Diabetes Mellitus: Diabetic Foot and Ankle Care, Peripheral Neuropathy – Neurological Evaluation
- Diabetes Mellitus: Diabetic Foot and Ankle Care, Ulcer Prevention – Evaluation of Footwear
- Preventive Care and Screening: Screening for Depression and Follow-Up Plan
- Falls: Risk Assessment
- Falls: Plan of Care
- Falls: Screening for Future Fall Risk
- Elder Maltreatment Screen and Follow-Up Plan
- Preventive Care and Screening: Tobacco Use: Screening and Cessation in Intervention
- Dementia: Cognitive Assessment
- Functional Status Change for Patients with Neck Impairment
APTA is pleased to see additional measures added to the set to allow therapists more measures to choose from that meet their practice needs and patient populations.
3. Increase in Required Data Completeness
For the Quality category, currently providers are required to submit data for at least 60% of Medicare Part B patients seen that year. CMS is proposing to increase that number to 70% for the 2020 reporting year.
4. Change in Requirement for Improvement Activity Credit for Groups
Currently, groups, including virtual groups, can attest to an improvement activity if at least 1 clinician in that group participates in that activity. However, under the proposed rule, at least 50% of group members would need to participate in or perform that activity, for the same continuous 90-day period in order to get credit for that activity.
For more information on the entire Medicare Physician Fee Schedule proposed rule, you can listen to APTA's August 15, 2019, Insider Intel webinar, available free to members. A follow-up live webinar is scheduled for later this year, after the rule is finalized.