Q: Since it says “billed charges”, if a facility was reimbursed $89,117 and that doesn’t include the 20% that was paid by the patient or secondary insurance, does that amount need to be added back in (which would put the clinic over the $90,000 threshold)? January 9, 2019January 9, 2019 hartjohnson Posted in MIPS FAQ's
Q: It says we are excluded if we bill $90,000/year or less. I’m assuming that’s $90,000 in charges after the contractual sets in. So as a clinic with 2 PT’s billing under 1 TIN, is the exclusions cap $180,000 in billed charges or is it still $90,000 for the whole clinic? If it’s $180,000, then if 1 therapist bills $91,000 and the other bills $85,000 are we still excluded? January 9, 2019January 9, 2019 hartjohnson Posted in MIPS FAQ's
Q: Is there a recommendation for the best way to advise a clinician whether it is worthwhile in terms of effort and time to only report quality measures and avoid a penalty or work toward an incentive/bonus and report Improvement Activities? We have practitioners asking for an equation or process they can use in helping to determine this. January 9, 2019January 9, 2019 hartjohnson Posted in MIPS FAQ's
Q: Is there somewhere online that a clinician can determine if he/she falls into the low volume threshold by NPI number? January 9, 2019January 9, 2019 hartjohnson Posted in MIPS FAQ's
Q: What happens if you are reporting individually and you either 1) Change organizations mid year and the new organization has a different method of reporting (i.e. the clinician was reporting with a group and now will be reporting individually)? January 9, 2019January 9, 2019 hartjohnson Posted in MIPS FAQ's
Q: For those physical and occupational therapists that do not meet all three of the low volume threshold criteria but choose to “opt in” to MIPS, is there anything official they have to do with CMS to let CMS know they are opting in? January 9, 2019January 9, 2019 hartjohnson Posted in MIPS FAQ's
