If you haven’t started reporting quality data for the Merit-Based Incentive Payment System (MIPS), there’s still time to avoid a 4% cut to your Medicare payments.
Under the Pick Your Pace approach being offered this year, the Centers for Medicare & Medicaid Services allows clinicians to test the system by reporting on one quality measure for one patient through paper-based claims. Be sure to append a Quality Data Code (QDC) to the claim form for care provided up to Dec. 31, 2017, in order to avoid a penalty in payment year 2019.
Consider this measure:
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Measure #134: Preventive Care and Screening: Screening for Depression and Follow-Up Plan
This measure aims to capture the percentage of patients aged 12 years and older who have been screened for depression and have a documented follow-up plan of care, if appropriate.
What you need to do: Use an age-appropriate, standardized tool to screen patients for depression during the visit. If they screen positive, develop a follow-up plan during the visit and document it.
Eligible cases include patients who were aged 12 years or older on the date of the encounter and have a patient encounter during the performance period. Applicable codes include (CPT or HCPCS): 90791, 90792, 90832, 90834, 90837, 92625, 96116, 96118, 96150, 96151, 97165, 97166, 97167, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, G0101, G0402, G0438, G0439, G0444.
To get credit under MIPS, be sure to include a QDC that shows that you successfully performed the measure or had a good reason for not doing so. For instance, G8431 indicates that depression screening was positive and a follow-up plan was documented, while G8510 indicates that the depression screening was negative and a follow-up plan is not required. Use exclusion code G9717 if the patient has an active diagnosis of depression for bipolar disorder.
CMS has a full list measures available for claims-based reporting at qpp.cms.gov. The American Medical Association has also created a step-by-step guide for reporting on one quality measure.
Certain clinicians are exempt from reporting and do not face a penalty under MIPS:
- Those who enrolled in Medicare for the first time during a performance period.
- Those who have Medicare Part B allowed charges of $30,000 or less.
- Those who have 100 or fewer Medicare Part B patients.
- Those who are significantly participating in an Advanced Alternative Payment Model (APM).