The 2019 Final Rule proposed by the CMS includes adding physical and occupational therapists as eligible clinicians for MIPS performance year. All that Therapists' need to know about 2019 Final Rule and have a successful approach to it!

1. Sanjay Patil is a Healthcare IT consultant with top-tier consulting experience in successfully
delivering large scale custom development projects, application integration, content manage-
ment ,portal solutions and implementation of health care business solutions. He has been
actively involved in Meaningful Use and is passionate about creating IT solutions for providers
w.r.t different regulatory programs. He has worked in delivering solutions across all product
lines such as EMR, EHR ,Care Co-ordination, Patient Engagement.
Therapists’ Guide
A Successful Approach to 2019 Final Rule
Sanjay Patil

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Background..............................................................................................
What is in the 2019 Final Rule?..............................................................
Requirements for Therapists to Participate in MIPS...........................
Reporting as a Group
Performance Categories
Documentation Requirement for Physical and...................................
Occupational Therapy
Treating without a Referral
Compliance Rules
Technology Engagement........................................................................
EMR Capability
MIPS Improvement
2019 Modification Highlights
1
1
2
5
7
Go Through

3. MIPS scoring and
Payment Adjustment
for the year 2019
2019 Modification
Highlights
Source : www.cms.gov
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Discontinuation of functional limitation reporting.
Increase in therapy soft cap at a higher threshold.
Deletion of two rehab therapy codes.
Increase in conversion factor.
Provision should be made to attach the KX
modifier after amount $2040
8 Copyright © 2019 Nalashaa
2019
PERFORMANCE THRESHOLD
2019 MIPS PAYMENT ADJUSTMENT
2019 MIPS SCORE (0 - 100 POINTS)
YOUR MIPS FINAL SOCRE = (QUALITY SCORE * 85%) + (IMPROVEMENT ACTIVITY SCORE * 15%)
0 10 20 30 40 50 60 70 80 90 10030
- PAYMENT
ADJUSTMENTS
+ PAYMENT
ADJUSTMENTS