CMS Releases 2018 Final Rules for Quality Payment Program and Physician Fee Schedule

On Thursday, November 2, the Centers for Medicare & Medicaid Services (CMS) released Final Rules for the 2018 Quality Payment Program (QPP) and 2018 Physician Fee Schedule (PFS).

The QPP Final Rule continues to build and improve upon CMS’ transition year policies and address elements of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) that were not included in the first year of the program, as well as includes an interim final rule with comment period to establish an automatic extreme and uncontrollable circumstance policy for the 2017 MIPS performance period that recognizes recent hurricanes (Harvey, Irma, and Maria) and other natural disasters that could effectively impede a Merit-based Incentive Payment System (MIPS) eligible clinician’s ability to participate in the program.

CMS makes payments under the PFS for services furnished by physicians and other practitioners in all sites of service and the Final Rule’s overall update to payments based on the finalized 2018 rates will be +0.41 percent. The Final Rule also includes the addition of several codes to the list of telehealth services and the elimination of a telehealth reporting requirement that reduces the administrative burden for practitioners. CMS also used the Final Rule to pledge to consider the stakeholder input the agency received in response to the proposed rule’s comment solicitation on how CMS could expand access to telehealth services, within its current statutory authority, and will consider this input in future rulemaking.

Look to HIMSS for more detailed analysis of both of these Final Rules in the coming days, as well as health IT-related provisions of other 2018 Final Payment Rules recently released by the agency.

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