Q&As and Articles

This TMF PDF answers questions about the Alternative Payment Model (APM) Performance Pathway (APP), which was introduced in 2021 by the Centers for Medicare & Medicaid Services (CMS) as a method of reporting and scoring the Merit-based Incentive Payment System (MIPS) for eligible clinicians who also participate in a MIPS APM.

Your electronic health record (EHR) system is an important tool in reporting your Merit-based Incentive Payment System (MIPS) data. This article provides a list of questions to consider asking your vendor to ensure you have the support you need to report MIPS.

This checklist is a tool for eligible clinicians and staff to prepare for and submit data for the 2021 Merit-based Incentive Payment System (MIPS) program.

CMS made numerous changes to the Merit-based Incentive Payment System (MIPS) Quality category for 2021. These changes may impact your Quality score in some of the measures that you typically report for MIPS. This article reviews some of those changes that may affect your choice of Quality measures.

There are two tracks in the Quality Payment Program (QPP) in which clinicians can choose to participate: the Merit-based Incentive Payment System (MIPS) or Advanced Alternative Payment Models (APMs). This article from TMF answers your questions about accountable care organizations (ACOs) and MIPS.

The Medicare Annual Wellness Visit (AWV) is an excellent way to perform needed services and capture Merit-based Incentive Payment System (MIPS) Quality measure data at the same time. This TMF article explains how.

Read this new Q&A by TMF to learn how Single Source documents can help identify applicable MIPS Quality measures for clinicians or practices.

The TMF MIPS Toolbox is designed to help practices develop a strategy for the Merit-based Incentive Payment System (MIPS). By using the Toolbox to model different scenarios, practices can make decisions to help increase their MIPS scores.

This TMF article (PDF) will introduce you to the Merit-based Incentive Payment System (MIPS) changes to look forward to this coming performance year.

Under MIPS, CMS conducts an annual data validation process. Clinicians are randomly selected for the audit.

This PDF explains the Security Risk Analysis (SRA), which is a requirement for the Promoting Interoperability (PI) category of the Merit-based Incentive Payment System (MIPS), as well as the HIPAA Security Rule.

This TMF PDF explains the Centers for Medicare & Medicaid Services' (CMS) enrollment systems — the Medicare Provider Enrollment, Chain, and Ownership System (PECOS), and the National Plan & Provider Enumeration System (NPPES) — which manage provider information and identifiers.

Typically patient portals require an email for a patient to create an account. If the patient or a family member does not have an email account to use for the patient portal, you can help them create one by converting their cellphone to an email address.

The events of 2020 may have resulted in challenges for clinicians participating in the Merit-based Incentive Payment System (MIPS) program. The Centers for Medicare & Medicaid Services (CMS) is aware of this and has developed additional opportunities for taking a hardship exception for MIPS reporting.

Explore the MIPS PI category exceptions or the measure-specific exclusions to determine whether any apply to you. The clinician or practice must also consider whether their final MIPS score will be higher by taking an overall exception for the entire PI category, or taking selective measure-specific exclusions and receiving a PI score. This PDF helps answer those questions.

This Quick-Start Guide helps you get started in five easy steps on TMF's MIPS Toolbox, a free online application to help eligible clinicians manage their participation in the Quality Payment Program’s Merit-based Incentive Payment System (MIPS).

The TMF MIPS Toolbox is a free online application to help eligible clinicians manage their participation in the Quality Payment Program’s Merit-based Incentive Payment System (MIPS). Here is a detailed instruction guide.

To increase network security, a mandatory update will be applied to the Quality Payment Program (QPP) systems in fall 2020. The Centers for Medicare & Medicaid Services (CMS) encourages you to test your web browser and make any necessary updates to ensure your continued access to qpp.cms.gov.

This TMF document provides detailed information about how your final Merit-based Incentive Payment System (MIPS) score will be calculated in 2020.

Logging into the QPP Portal now requires HARP credentials. This Q&A explains how to get those credentials and log in.

Clinicians are required to use 2015 Edition certified electronic health record technology (CEHRT) for the Promoting Interoperability category of the Merit-based Incentive Payment System (MIPS). The Centers for Medicare & Medicaid Services (CMS) require clinicians to include their CMS CEHRT ID when reporting. Use this guide to find your number.

This article guides practices in how to meet this measure in MIPS.

The following telehealth information is based on regulations declared by the Secretary of Health and Human Services (HHS) on Jan. 31, 2020, and will be effective until the Secretary ends the COVID-19 Public Health Emergency.

The Centers for Medicare & Medicaid Services (CMS) announced that Medicare would allow for expanded access to reimbursement for telehealth services as a result of the COVID-19 public health emergency. This expansion will help improve patient access to medical care, while minimizing requirements for patients to travel from their homes, and minimize burden on the overall health care system.

Chronic care management is a critical component of primary care that contributes to better outcomes and higher satisfaction for patients with two or more chronic conditions. Read this questions and answer document to learn more.

This article explains MIPS Special Status and Hardship exceptions.

Merit-based Incentive Payment System (MIPS)-eligible clinicians are eligible for facility-based measurement for a MIPS payment year if they are determined to be facility-based as an individual clinician or as part of a group. This article discusses eligibility and actions steps for using these measures to report MIPS.

This Merit-based Incentive Payment System (MIPS) reporting checklist will guide you through the data submission process. You should begin these steps as soon as possible, and before the end of the performance year.

The Public Health and Clinical Data Exchange objective and its related measures have proven to be quite a challenge to many clinicians and their practices. This objective is now required to fulfill the Promoting Interoperability category requirements. This article will guide practices in how to meet this measure in the upcoming data submission.

The Merit-based Incentive Payment System (MIPS) has provided the same data submission mechanisms since it began in 2017. The guidance regarding reporting with more than one submission method has changed this year, and this article addresses those changes.

In 2019, the Merit-based Incentive Payment System (MIPS) requires 2015 Edition certified electronic health record technology (CEHRT) to be used for reporting both the Promoting Interoperability and Quality categories. This article answers common questions about using and updating 2015 Edition CEHRT effectively.

Coding encompasses more than just the claim codes used for reimbursement and quality data submission. This article addresses common questions regarding the use of coding for all collection methods for the Quality and Cost categories of the Merit-based Incentive Payment System (MIPS).

Understanding Hierarchical Condition Categories (HCC) and their applicability to the Merit-based Incentive Payment System (MIPS) is important as clinicians work to receive recognition for the care they deliver to patients with complex conditions. Beneficiaries with complex health conditions may take additional time and resources to achieve positive health outcomes, and HCC helps recognize the complexity of that care.

In 2019, seven new Merit-based Incentive Payment System (MIPS)-eligible clinician types were added: physical therapist, occupational therapist, speech-language pathologist, audiologist, clinical psychologist, and registered dietitian or nutritional professional. This Q&A article covers common questions from newly eligible clinician types.

The Promoting Interoperability (PI) category of the Merit-based Incentive Payment System (MIPS) promotes patient engagement and the electronic exchange of information using certified electronic health record technology (CEHRT). The Centers for Medicare & Medicaid Services (CMS) has modified the PI category in 2019. This Q&A article answers frequently asked questions about PI.