Author: Mario P. Fucinari DC, CPCO, CPPM, CIC

Medicare Releases Quality Payment Updates for 2019

On November 1, 2019, year 3 of the Medicare Quality Payment Program (QPP), key factors were released. Beginning in January 2019, the definition of eligible providers has been expanded to include physical therapists, occupational therapists, speech-language pathologists, audiologists, clinical psychologists, and registered dietitians or nutrition professionals.

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Avoid Duplication of Diagnoses​

Although multiple segments or regions may be involved in the cause of a patient’s ailment, it is important to identify the main segment or region and report the diagnosis specifically. Medicare has recently reaffirmed that duplication of diagnoses in Box 21 on the claim form will be denied. Each area treated must have a unique diagnosis.

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Medicare Fees Increase (for some)

Congress passed the Bipartisan Budget Act of 2018 on 2/9/2018, changing the Medicare physician fee schedule and the processing of Medicare services. Section 50201 of this Act has made a change to the work Geographic Practice Cost Index (GPCI) floor, effective retroactive to 1/1/2018. Any area that previously was in an area with a work GPCI of less than 1.000 will be impacted.

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