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You are here: Home / Articles / Possible MIPS Errors in 2019 Payment Adjustment

Possible MIPS Errors in 2019 Payment Adjustment

February 8, 2019 • By From the College

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Recently, the Centers for Medicare and Medicaid Services (CMS) discovered an error in the implementation of the 2019 Merit-Based Incentive Payment System (MIPS) payment adjustment. It incorrectly applies adjustments to payments for Medicare Part B drugs and other non-physician services billed by physicians. Adjustments to affected claims will occur in the near future. According to the CMS, you don’t need to do anything. A CMS statement says,

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  • “If we overpaid a claim based on this error, you will get a notification for recoupment from your Medicare Administrative Contractor.
  • “If we underpaid a claim, it will be adjusted.”

Please be aware that adjustments to reimbursement for Part B drugs could be between +4% and -4%, depending on your practice’s MIPS adjustment based on 2017 performance.

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The ACR encourages practices to review a sampling of their payments from Medicare with focus on MIPS adjustments, since excess drug payment recoupments could come as a surprise for those who don’t realize they were overcompensated to begin with.

Filed Under: From the College, Practice Management Tagged With: 2019 MIPS payment adjustment errors, Medicare Part B drugs, Merit-Based Incentive Payment System (MIPS)

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  • Avoid the 2015 PQRS Negative Payment Adjustment
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ISSN 1931-3268 (print)
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