2020 MIPS IA_CC_19: Tracking of clinician's relationship to and responsibility for a patient by reporting MACRA patient relationship codes.

Activity ID

Subcategory Name

Care Coordination

Activity Description

To receive credit for this improvement activity, a MIPS eligible clinician must attest that they reported MACRA patient relationship codes (PRC) using the applicable HCPCS modifiers on 50 percent or more of their Medicare claims for a minimum of a continuous 90-day period within the performance period. Reporting the PRC modifiers enables the identification of a clinician’s relationship with, and responsibility for, a patient at the time of furnishing an item or service. See the CY 2018 PFS final rule (82 FR 53232 through 53234) for more details on these codes.

Validation

MIPS eligible clinicians and groups must attest that they reported MACRA patient relationship codes (PRC) using the applicable HCPCS modifiers on 50 percent or more of their Medicare claims for a continuous 90-day minimum reporting period within the performance year. Reporting the PRC modifiers enables the identification of a clinician’s relationship with, and responsibility for, a patient at the time of furnishing an item or service.

Suggested Documentation

The MIPS eligible clinician or group must demonstrate with documentation that the provider implemented Patient Relationship Codes (PRC) applicable to HCPCS modifiers within their processes of care.  Documentation could be captured in the patient chart or EHR note that the MIPS eligible clinician reported MACRA PRC using the applicable HCPCS modifiers on 50 percent or more of their Medicare claims for a continuous 90-day minimum reporting period within the performance year.