Centers for Medicare and Medicaid Services (CMS) has recently released the final ruling for this year’s Medicare physician fee schedule. These changes include some exciting new regulations and rules for chronic care management. One change will be new...
Today let’s look at communication between nurses and doctors. Communication is key when dealing with chronic care management. When communication is not key, disconnects can occur from simple misinterpretations, which can result in incorrect...
In part 1 & 2 of this series we defined the criteria for patients’ qualification for Chronic Care Management. We’ve also identified three subsections of patient needs in Chronic Care Management. In this installment, let’s look at one more Highest Risk...
In part 1 of “How To Qualify Your Patients For CCM,” we defined the eligibility of the patient for such a program, and we determined that the highest risk patient would be the one who was recently hospitalized or is regularly in the ER. With this...
Let’s take a look at how you might go about managing your chronic care patients. How do you add Chronic Care Management to your menu of services already underway in your practice? You’re looking at the vast number of patients in your current practice, and...
To continue our series of “Tough Questions” we created a situation with a theoretical patient in which posed us with the ethical dilemma of determining whether the patient was going to be able to continue with their chronic care management program. This patient had...
The Quality Payment Program automatically assigns special statuses to Merit-based Incentive Payment System (MIPS) eligible clinicians, practices, and virtual groups who meet certain criteria. If you receive a special status, your reporting requirements may be...
Now that you’ve determined that you are a MIPS eligible clinician, let’s look at some next steps. We’ll break it down into three categories: MIPS Eligible Clinician, Opt-in Eligible Clinician, and MIPS Exempt Clinician. MIPS Eligible Clinician If you’re a...
In the Quality Payment Program, there are certain factors, including Special Statuses, QPP Exceptions, Facility-based Determinations, MAQI and the Quality Measures Reporting Study, that can affect your reporting requirements for the different performance categories....
If you are Merit-based Incentive Payment System (MIPS)-eligible, you can choose to participate as an individual, a group, or both. Here’s a summary of how to report in these three categories. Additional clarification follows for virtual groups, MIPS APMs, and...