Three CMS Reimbursement Updates Applicable to Emergency Physicians

There have been three important reimbursement items at the federal level over the last few months. We've compiled them here.

Medicare reimbursement rises for most

Breathe easier: Instead of a cut to Medicare reimbursement in 2021, now, with the passage of the major omnibus bill at the end of 2020, many of you will actually see an increase in your Medicare reimbursement. And since many private payers use Medicare payment levels to set their rates, you hopefully will receive some much-needed financial security during a difficult time. Read more.

New Automatic Exemption for MIPS

CMS announced relief to Merit-based Incentive Payment System (MIPS) reporting requirements due to the pandemic. MIPS is the major quality reporting program in Medicare for physicians. The relief and change in policy: Those participating in MIPS (most emergency physicians) will receive an automatic exemption from all four MIPS performance categories (Quality, Cost, Improvement Activities, and Promoting Interoperability) if they do not report any data from the 2020 performance period. In other words, if you haven’t yet reported data and choose not to do so, you will be held harmless and will not receive a bonus or penalty in 2022 based on your performance in MIPS in 2020.

There’s a deadline of March 31, 2020 at 8 p.m. EST for submitting a hardship exemption application for participating in MIPS. Learn more.

COVID-19 vaccine reimbursement

On March 15, CMS increased the Medicare payment rate for the administration of the COVID-19 vaccine. The rate for physicians, hospitals, pharmacies, and many other immunizers will be $40 to administer each dose. This represents an increase from approximately $28 to $40 for the administration of single-dose vaccines and an increase from approximately $45 to $80 for the administration of COVID-19 vaccines requiring two doses. Click here for an overview of reimbursement policies.