CMS issues 2018 Medicare physician fee schedule final rule and MACRA physician QPP final rule

On November 2, 2017, the Centers for Medicare & Medicaid (CMS) Services issued its Calendar Year (CY) 2018 Medicare Physician Fee Schedule (MPFS) final rule.  The overall update to payments under the MPFS in 2018 will be +0.41 percent.  The 2018 MPFS conversion factor will be $35.99, an increase from $35.89 in 2017.  MPFS payment rates for non-excepted off-campus provider-based departments will be reduced from 50 percent of the outpatient prospective payment system (OPPS) payment rate to 40 percent of the OPPS rate.  The final rule adds five codes (HCPCS and CPT) to the list of telehealth services.  A CMS fact sheet describing the MPFS final rule is available here and the final rule is available here. 

On November 2, CMS also issued a final rule with comment period for the second year of the Quality Payment Program (QPP), as mandated by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).  Under the final rule CMS will increase the Merit-Based Incentive Payment System (MIPS) low-volume threshold, which will effectively exclude more than 540,000 clinicians from the program.  Specifically, the final rule excludes individual MIPS-eligible clinicians or groups with equal to or less than $90,000 in Medicare Part B allowed charges or equal to or less than 200 Medicare Part B beneficiaries.  A CMS fact sheet explaining the final rule is available here.  The final rule is available here.