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The Quality Payment Program is delaying a major overhaul planned for 2021: Its MVP (MIPS Value Pathways) upgrade, which was meant to move participants “away from siloed activities and measures and towards an aligned set of measures that are more relevant to a clinician’s scope of practice,” has been delayed due to “stakeholder concerns” and COVID-19. Instead, CMS will make “additions to the framework’s guiding principles and development criteria” for 2022.
 
 
You can expect to see wild swings to Medicare pay rates in 2021, according to proposals CMS released this morning. The agency announced a nearly 11% cut to the Medicare physician fee schedule’s conversion factor (CF), dropping it to a rate of $32.26 next year, down from $36.09 in 2020.
 
Influencing the substantial decrease to the CF are the projected pay increases to the core set of E/M office visit codes (99202-99215). CMS confirmed that the E/M office visit codes remain on track for their first major overhaul in 25 years, according to the proposed 2021 Medicare physician fee schedule.
 
Get ready to update your Advance Beneficiary Notice of non-coverage (ABN) forms. Medicare has released a new form and instructions that will be mandatory on Aug. 31. The new forms have a 06/30/2023 expiration date in the footer and your practice may use them now.
Would you report 24 office visits for the same patient on the same day? What about a solid 24 hours of psychotherapy? You’ll be able to starting July 1, according to the medically unlikely edit (MUE) change file that CMS posted today.
 
Providers gained a substantial pay boost for audio-only E/M encounters (99441-99443) under recent CMS rulemaking -- and the path to those payments for claims you already submitted just got easier.
 
 

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