Healthmonix Advisor

The long-awaited CY 2021 Medicare Physician Fee Schedule Final Rule update is now here. Despite the disruptions of the Public Health Emergency COVID-19, participation in performance year 2019 was strong. Thus the 2021 Final Rule moved forward with finalizing a number of proposed changes, including a higher performance threshold for performance year 2021, anticipated changes in weight to the Quality and Cost performance categories of the Merit-based Incentive Payment System (MIPS), and the introduction of the APM Performance Pathway. Other expected initiatives, such as MIPS Value Pathways, the requirement for registries to build their own benchmarks for certain measures, and the sunsetting of the CMS Web Interface, have been pushed back to at least the 2022 performance year.

We call it “Informal Review Season”.  You could also call it “the Nightmare Vaguely Before Christmas” for
 providers who bill Medicare Part B services.  The 2015 PQRS Informal Review season (this year September 26th through November 30th) is that most wonderful time of the year when practitioners and practice administrators nervously await the release of feedback reports in September.  Instead of children wondering whether or not they’ve made Santa’s list, you’ve got providers and practitioners feverishly paging through their QRURs to see exactly how naughty or nice they are, according to CMS.  (Note: Documents released in the fall of 2016 pertain to the 2015 PQRS or VBM reporting period).