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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 hartjohnsonPosted in MIPS FAQ's

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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?
Q: Did I hear that correctly that practices with more than 15 clinicians cannot report quality by way of claims?
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