How Telemedicine is Relevant to Your MIPS Reporting

Posted on June 11, 2020
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The COVID-19 pandemic has brought many changes to our daily lives, including a surge in the use of telemedicine. During the past few months, more clinicians and their patients have been turning to telehealth appointments so patients can safely receive the care they need. In response, CMS announced many changes to support telehealth, including payments for Medicare telehealth services furnished to patients in broadened circumstances and an expanded list of clinicians who can provide these services. Clinicians offering telehealth services to their patients may want to consider how this is relevant to their MIPS reporting. In this article, we have identified a list of Quality measures and Improvement Activities that can be reported for telemedicine services.

Telehealth and MIPS Reporting

CMS has expanded the use and reimbursement of telehealth services beginning on March 6, 2020 which will last through the duration of the COVID-19 Public Health Emergency. If you have recently adopted or expanded the use of telehealth services in your practice, it may help you fulfill some of your MIPS reporting requirements this year.

Quality

For 2020, the Quality category is worth 45% of your final MIPS score. As in prior years, you should select 6 Quality measures to report, including an Outcome or other High Priority measure. Each measure should be reported on at least 70% of your eligible cases for the year (up from 60% in 2019). If you have been using telehealth to care for any of your patients and have eligible CPT codes, some may be eligible for your MIPS Quality reporting. We have identified the following list of Quality measures that can be reported for telemedicine services in 2020:

Measure #Measure Name
1Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
24Communication with the Physician or Other Clinician Managing On-Going Care Post-Fracture for Men and Women Aged 50 Years and Older
39Screening for Osteoporosis for Women Aged 65-85 Years of Age
47Advance Care Plan
48Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older
50Urinary Incontinence: Plan of Care for Urinary Incontinence in Women Aged 65 Years and Older
65Appropriate Treatment for Children with Upper Respiratory Infection (URI)
66Appropriate Testing for Children with Pharyngitis
111Pneumococcal Vaccination Status for Older Adults
112Breast Cancer Screening
113Colorectal Cancer Screening
116Avoidance of Antibiotic Treatment in Adults With Acute Bronchitis
117Diabetes: Eye Exam
119Diabetes: Medical Attention for Nephropathy
130Documentation of Current Medications in the Medical Record
134Preventive Care and Screening: Screening for Depression and Follow-Up Plan
154Falls: Risk Assessment
155Falls: Plan of Care
182Functional Outcome Assessment
205HIV/AIDS: Sexually Transmitted Disease Screening for Chlamydia, Gonorrhea, and Syphilis
217Functional Status Change for Patients with Knee Impairments
218Functional Status Change for Patients with Hip Impairments
219Functional Status Change for Patients with Lower Leg, Foot or Ankle Impairments
220Functional Status Change for Patients with Low Back Impairments
221Functional Status Change for Patients with Shoulder Impairments
222Functional Status Change for Patients with Elbow, Wrist or Hand Impairments
236Controlling High Blood Pressure
238Use of High-Risk Medications in the Elderly
275Inflammatory Bowel Disease (IBD): Assessment of Hepatitis B Virus (HBV) Status Before Initiating Anti-TNF (Tumor Necrosis Factor) Therapy
338HIV Viral Load Suppression
340HIV Medical Visit Frequency
370Depression Remission at Twelve Months
383Adherence to Antipsychotic Medications For Individuals with Schizophrenia
390Hepatitis C: Discussion and Shared Decision Making Surrounding Treatment Options
391Follow-Up After Hospitalization for Mental Illness (FUH)
394Immunizations for Adolescents
398Optimal Asthma Control
401Hepatitis C: Screening for Hepatocellular Carcinoma (HCC) in Patients with Cirrhosis
402Tobacco Use and Help with Quitting Among Adolescents
418Osteoporosis Management in Women Who Had a Fracture
441Ischemic Vascular Disease (IVD) All or None Outcome Measure (Optimal Control)
443Non-Recommended Cervical Cancer Screening in Adolescent Females
444Medication Management for People with Asthma
450Trastuzumab Received By Patients With AJCC Stage I (T1c) – III And HER2 Positive Breast Cancer Receiving Adjuvant Chemotherapy
451RAS (KRAS and NRAS) Gene Mutation Testing Performed for Patients with Metastatic Colorectal Cancer who receive Anti-epidermal Growth Factor Receptor (EGFR) Monoclonal Antibody Therapy
452Patients with Metastatic Colorectal Cancer and RAS (KRAS or NRAS) Gene Mutation Spared Treatment with Anti-epidermal Growth Factor Receptor (EGFR) Monoclonal Antibodies
453Percentage of Patients Who Died from Cancer Receiving Chemotherapy in the Last 14 Days of Life (lower score – better)
455Percentage of Patients Who Died from Cancer Admitted to the Intensive Care Unit (ICU) in the Last 30 Days of Life (lower score – better)
457Percentage of Patients Who Died from Cancer Admitted to Hospice for Less than 3 days (lower score – better)

 

Improvement Activities

The Improvement Activities (IA) category is worth 15% of your final MIPS score. Clinicians must attest to activities for a consecutive 90 day reporting period. If reporting as a group, at least 50% of clinicians must participate in IA for group reporting. To receive full credit for this category, small practices must attest to 1 high-weighted or 2 medium-weight activities. Large practices (16 or more clinicians) must report more activities:

  • 2 high-weighted activities; OR
  • 1 high-weighted activity and 2 medium-weighted activities; OR
  • 4 medium-weighted activities

You may be able to receive IA credit for some of your telehealth activities. The MIPS IA_EPA_2: Use of telehealth services that expand practice access is a medium-weighted activity. You can attest to this IA if you use telehealth services and analysis of data for quality improvement, such as participation in remote specialty care consults or teleaudiology pilots that assess ability to still deliver quality care to patients. It is easy to attest to this activity in your MDinteractive account.

While not specific to telehealth services, CMS has also added a new high-weighted activity (IA_ERP_3) for 2020 that promotes participation in COVID-19 clinical trials and reporting COVID-19 related care data to a clinical data repository or clinical data registry for the duration of their study. This high-weighted IA was added to provide an opportunity for clinicians to receive credit in MIPS for the important work they are doing across the country to fight COVID-19. To receive credit for the new COVID-19 clinical trials (IA_ERP_3) IA, MIPS eligible clinicians must attest to participation in a COVID-19 clinical trial utilizing a drug or biological product to treat a patient with a COVID-19 infection and report their findings through a clinical data repository or clinical data registry.

More Resources

The COVID-19 pandemic has given rise to the use of telehealth services, significantly impacting the way clinicians are delivering health care across the country. If you have been caring for some of your patients via telehealth, it may help you meet some of your MIPS Quality and Improvement Activity reporting requirements. The federal government has launched a website with more information on COVID-related telehealth services that you may find helpful. As your MIPS partner, we will continue to provide you with relevant information we believe can support your MIPS reporting activities.

2020 MIPS Reporting Telemedicine Telehealth

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