New Year’s resolutions for your GI practice in 2020
6. Review your commercial contracts. With reimbursement decreasing each year, protect yourself by renegotiating multi-year contract rates now with payers based on the 2019 fee schedule. Review all your commercial contracts and focus on the ones with the lowest rates first. Prepare a case to justify higher rates by creating a value proposition and don’t forget to involve your coders; they are often aware of payer-specific reimbursement problems. Not comfortable negotiating with payers? Be open to looking for outside help, like a contract attorney.
7. Mark your calendars! Here’s a list of dates that you will want to put on your calendar for 2020!
December 2019
December 31 - MIPS Performance Year 2019 Ends
December 31 - Quality Payment Program Exception Applications Window Closes
December 31 - Fourth snapshot date for full TIN APMs (Medicare Shared Savings Program) for determining which eligible clinicians are participating in a MIPS APM for purposes of the APM scoring standard.
January 2020
January 1 - MIPS Performance Year 2019 Begins
January 2 - Submission Window Opens for MIPS Performance Year 2019
March 2020
March 31 - Submission Window Closes for MIPS Performance Year 2019
July 2020
• CMS publishes proposed reimbursement values for the E/M codes in the 2021 MPFS proposed rule
• CMS “Targeted Review” opens once CMS makes your MIPS payment adjustment available
• July 1 - MIPS Performance Feedback Available. CMS will provide you with performance feedback based on the data you submitted for Performance Year 2019. You can use this feedback to improve your care and optimize the payments you receive from CMS.
August 2020
August 31 - Targeted Review period closes (appeals process)
September 2020
AMA releases CPT 2021 book with new E/M coding guidelines and new coding for new patient office/outpatient visits (99202-99205)
October 2020
October 1, 2020 – Final day to start QPP activities to meet 90-day minimum.
November 2020
CMS finalizes reimbursement values for the E/M codes in the MPFS final rule
December 2020
December 31, 2020 - Quality Payment Program Exception Applications Window Closes
December 31, 2020 – MIPS Performance year 2020 ends
Stress to your team that proper planning is the norm and not the exception, and that seeking improvement in all facets of your medical practice is critical to achieving long-term success. Be sure to write your plans in the future tense and to include timelines in your final work product, as well as delegate accountability to accomplish those goals.
Use the planning process as an opportunity to build your team so that everyone is focused on the future and stress that their participation is important to achieve the success required to remain an independent medical group.
Mr. Turner is chief executive officer, Indianapolis Gastroenterology and Hepatology, Indianapolis. jturner@indygastro.com
