2020 MIPS Changes: What You Need To Know

If you are participating in the Merit-Based Incentive Payment System (MIPS) this year, there are some key changes to the program for the 2020 performance period.¹  

• Participants need a score of 45 MIPS points in 2020 to avoid a penalty in 2022.
• Earning zero MIPS points in 2020 will result in a negative nine percent adjustment to your 2022 Medicare Part B Physician Fee Schedule.

What About Quality Category Changes?

• To achieve a perfect score on a Quality measure, one must report that measure on at least 70 percent of his or her patients who qualify for that measure. This is an increase of 10 percent from 2019.
• The Quality measure #131, “Pain Assessment and Follow-Up” has been deleted.
• When reporting via claims that a patient’s hemoglobin A1c (HbA1c) was between 7.0 percent to 9.0 percent for Quality measure #1, “Diabetes: HbA1c Poor Control,” the code has changed from Current Procedural Terminology (CPT) 3045F to G2089.
• Some of the reporting codes for Quality measure #117 have changed. CPT 2022F changed to G2102. CPT 2024F changed to G2103. CPT 2026F changed to G2104.

A Quick Summary Of Improvement Activity Changes

• If reporting as a group, at least 50 percent of the eligible providers in a group must report performance of an Improvement Activity in order for the group to earn credit for the activity.
• Reporting Patient Responsibility Categories and Codes on 50 percent or more of Medicare Part B claims for 90 consecutive days is a new high weight Improvement activity.
• The medium weight Improvement Activity, “Annual Registration in the Prescription Drug Monitoring Program” has been deleted.
• The medium weight Improvement Activity, “Initiate CDC Training on Antibiotic Stewardship” has been deleted.

Dr. Lehrman operates Lehrman Consulting, LLC, is a consultant to the APMA Health Policy and Practice Department, serves as an expert panelist on Codingline, and is a Certified Professional Coder. Follow him on Twitter @DrLehrman.

References

1. Quality Payment Program. Available at: https://qpp.cms.gov . Accessed March 6, 2020.