Monday Morning Rounds with CMS

ICYMI, here is recent communication from CMS.

Reminder: Important upcoming Merit-based Incentive Payment System (MIPS) dates and deadlines.

  • December 31, 2020
  • January 4, 2021
  • March 1, 2021
  • March 31, 2021

AI Health Outcomes Challenge: CMS announced the Participants (the Finalists) selected to advance to Stage 2 of the CMS Artificial Intelligence (AI) Health Outcomes Challenge. The CMS AI Challenge was launched in March 2019 by the CMS Innovation Center in collaboration with the American Academy of Family Physicians and Arnold Ventures (formerly the Laura and John Arnold Foundation).

Under federal law, Qualifying Alternative Payment Model (APM) Participant (QP) thresholds are increasing beginning on January 1, 2021. If you were a QP for the 2020 performance year, you may not necessarily receive QP status for the 2021 performance year. Depending on your status in 2021, you may be required to participate in the Merit-based Incentive Payment System (MIPS) even if you haven’t in previous years.

New Quality Payment Program (QPP) resources to the QPP Resource Library available on the QPP website.

COVID-19 Non-Physician Practitioner Billing for CPT Codes 98966-98968 – During the COVID-19 Public Health Emergency (PHE), non-physician practitioners who are eligible to bill Medicare directly, including registered dietitians and nutrition professionals, may bill for audio-only telephone assessment and management services. Dates of service on or after March 1 until the end of the PHE.

MLN Matters Articles

From CMS Innovation Center

The Centers for Medicare & Medicaid Services Innovation Center, also known as “CMMI,” develops and tests new healthcare payment and service delivery models.

Announced: Third annual report and associated materials posted
The Comprehensive Care for Joint Replacement (CJR) model aims to support better and more efficient care for beneficiaries undergoing the most common inpatient surgeries for Medicare beneficiaries: hip and knee replacements (also called lower extremity joint replacements or LEJR).

Announced: Performance year three annual report and associated materials posted
The Comprehensive ESRD Care (CEC) Model is designed to identify, test, and evaluate new ways to improve care for Medicare beneficiaries with End-Stage Renal Disease (ESRD). Through the CEC Model, CMS will partner with health care providers and suppliers to test the effectiveness of a new payment and service delivery model in providing beneficiaries with person-centered, high-quality care.

Radiation Oncology (RO) Model Billing Webinar
December 4, 2020 at 1:00 PM – The Radiation Oncology (RO) Model team will host a RO Model Billing webinar to provide an in-depth look at the RO Model billing practices.