The Centre for Medicare and Medicaid Services (CMS) recently announced that the link provided by them to the providers to check their participation status on the national portal i.e., https://qpp.cms.gov/participation-lookup/ was incorrect. Now the newly updated link for verifying the eligibility status for QPP participation has been updated to https://qpp.cms.gov/login. Providers have to report their National Provider Identifier on the latter link to check their 2020 participation status. The deadline for QPP reporting for 2019 is March 31, 2020, EST.
If you were qualified for the QPP participation last year, you should report on the link to participate and avail of the incentive. CMS has made it mandatory for providers who qualify to participate in the process; otherwise, they will face a penalty of 9% on their Medicare Part B reimbursement two years from now. To avoid this penalty, providers need to attain a minimum of 45 points. Physicians who did not qualify for the program can also opt-in, bearing in mind the restriction mentioned above.
To be eligible for QPP and avail the discount, you need to be a practitioner of one of the following professions:
- Doctors of medicine
- Podiatric medicine
The list of participating providers also includes advanced practice professionals and clinicians, such as:
- Clinical nurse specialists
- Physician assistants
- Nurse practitioners
- Registered dietitians or nutrition professionals
- Qualified speech-language pathologists
- Occupational therapists
- Physical therapists
- Clinical psychologists
- Qualified audiologists
- Certified registered nurse anaesthetists
There are four categories for the provider’s reporting:
- Promoting Interoperability
- Practice Improvement
Since CMS makes its judgment based on the claims submitted for the patients attributed by you, providers need not report on the cost category. Providers need to report on the other three categories on or before March 31, 2020, at 8:00 pm EST.
The participation guidelines to determine the eligibility status are:
- Attend to more than 200 part b patients;
- Provide more than 200 Part B of professional service.
- Bill, more than $ 90000 for Part B, covered professionals service.
The payouts for 2020 as per the 2018 participation has gone slightly low to 1.68% compared to 1.88% last year. When asked about the payment adjustments, CMS representative said, “As the program matures, we expect that the increases in the performance thresholds in future program years will create a smaller distribution of positive payment adjustments.”
It is important to note that billing made under the physician’s name will not qualify under the participation guidelines if the APP billing is incident to the physician under the Medicare services.
For more information, log on to https://qpp.cms.gov/mips/how-eligibility-is-determined?py=2020.
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