Blue Shield to update fee schedule effective December 1

April 23, 2020
Area(s) of Interest: Payor Issues and Reimbursement 

Physicians who plan to report on 2019 measures for the Medicare Quality Reporting Program (QPP) must do so by April 30, 2020. Due to the COVID-19 public health emergency, reporting for 2019 measures is optional. Clinicians who have not submitted any Merit-Based Incentive Payment System (MIPS) data by April 30, 2020, will qualify for the automatic extreme and uncontrollable circumstances policy and will receive a neutral payment adjustment for the 2021 MIPS payment year. Physicians do not need to take any additional action to qualify for the automatic extreme and uncontrollable circumstances policy.

However, if a MIPS eligible clinician submits data on two or more MIPS performance categories, they will be scored and receive a 2021 MIPS payment adjustment based on their 2019 MIPS final score.

Additionally, no data reflecting services provided January 1, 2020 through June 30, 2020, will be used in CMS’s calculations for the Medicare quality reporting and value-based purchasing programs. These exceptions have been made to reduce the data collection and reporting burden on providers responding to the COVID-19 pandemic.

CMS is continuing to monitor the developing COVID-19 situation and will assess options for additional relief to clinicians, facilities and their staff so they can focus on caring for patients during this time.

The full list of exemptions and extensions that have been granted can be found here.


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