Industry News

For Money Tree Billing clients, if you are thinking about VOLUNTARILY opting in to participate, please contact MTB for help with the new codes & new MIPS process.

As many of you already know, the G8730 Reporting code has been deleted for 2021. This is prompting many of you to ask about MIPS.

Below are the requirements for MIPS, most Chiropractic clinics will not meet this criteira and will be able to STOP reporting the G codes altogether. If you are unsure of your participation requirements, use the link to the lookup tool and with your NPI number you will be able to see if you are required to participate.

You can now use the updated Quality Payment Program Participation Status Tool to check on your initial 2021 eligibility for the Merit-based Incentive Payment System (MIPS).

LINK to LOOKUP: https://qpp.cms.gov/participation-lookup/

Just enter your National Provider Identifier, or NPI, to find out whether you need to participate in MIPS during the 2021 performance year.

Low-Volume Threshold Requirements

To be eligible to participate in MIPS in 2021, you must:

  • Bill more than $90,000 a year in allowed charges for covered professional services under the Medicare Physician Fee Schedule (PFS); AND
  • Furnish covered professional services to more than 200 Medicare Part B beneficiaries; AND
  • Provide more than 200 covered professional services under the PFS.

If you do not exceed all 3 of the above criteria for the 2021 performance year, you are excluded from MIPS. However, you have the opportunity to opt-in to MIPS and receive a payment adjustment if you meet or exceed 1 or 2, but not all, of the low-volume threshold criteria. Alternatively, you may choose to voluntarily report to MIPS and not receive a payment adjustment if you do not meet any of the low-volume threshold criteria or if you meet some, but not all, of the criteria.

Please note, beginning in 2021, the Centers for Medicare & Medicaid Services (CMS) will evaluate the low-volume threshold for MIPS Alternative Payment Model (APM) participants at the individual or group level, just as it does for participants who are not in MIPS APMs. CMS will no longer evaluate APM Entities for the low-volume threshold.

 

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