It’s never too early to start preparing for the Quality Payment Program (QPP). We’re sharing four tips to help you better prepare for the QPP program year 2021.
For questions, contact us for no-cost support: Call 877-273-0129 or email NEQPPSURS@healthcentricadvisors.org.
Determine your Eligibility for the Merit-based Incentive Payment System (MIPS).
- Only clinicians who are MIPS eligible as an individual are required to participate.
- Additionally, clinicians who are eligible to opt into MIPS as an individual or group can report MIPS data and will be also be eligible for payment adjustments.
Are you eligible? Check your eligibility status:
- Enter your 10-digit National Provider Identifier (NPI) number in “QPP Participation Status” field.
- Click on the orange “Check All Years” button.
- Click on the current calendar year tab to see if you are MIPS eligible as an individual, group, or eligible to opt-in as an individual or group.
As a MIPS-eligible clinician, determine your reporting requirements.
- If you’re a MIPS-eligible clinician, do you understand your reporting requirements? Are you exempt from Promoting Interoperability? Is a Hardship Exception available?
- Certain factors can affect your reporting requirements for each performance category, including Special Statuses, QPP Exceptions, Facility-based Determinations. These factors can reduce or eliminate reporting requirements for a specific category.
Where do I begin? How should I prepare for reporting?
- First, decide if you will report as an individual, group or virtual group.
- Then, decide how you will submit your data.
- Submission options for 2021 include: claims, attestation, registry, and qualified clinical data registry
Have you decided how will you report to CMS? EMR vs Paper Claims:
Report with your EMR:
- Determine if your EMR Technology is certified to the existing 2015 Edition certification criteria. For questions, contact your Administrator.
- Choose 6 measures including 1 Outcome or High Priority Measure.
- Determine if you need to attest via the QPP Portal (QRDA III File) or if your Vendor will submit on your behalf. For questions, contact your QPP Advisor.
Report via Claims:
- Determine your 6 measures based upon your specialty and CPT Codes.
- Tip: Make sure you are using the correct non-billable codes (many are “G” codes).
- Only reporting on Medicare Part B patients only.
- Make sure you have an ID and Password for the QPP Portal.
- Tip: CMS offers a Small Practice Exception (small practice with no EMR). Make sure you complete the Exception application before Dec. 31 to reweigh the 25 points into Quality category.