Clinicians who are adept at quality performance will have no trouble adjusting to the faster pace CMS has set for 2018. In addition, clinicians who improve their performance on two metrics next year will get extra credit that may help them avoid the pay cut. However, all eligible clinicians need to watch out for cost, which is making an early return.

CMS will set payments for certain services performed by off-campus provider-based departments (PBDs) at 40% of the hospital outpatient prospective payment system (OPPS) rate next year, down from 50% this year — effectively cutting their fees by 20%. The agency had originally proposed to cut next year’s payments to 25% of OPPS rates.

There’s good news for veterans of the physician quality reporting system: getting full credit for the quality leg of the merit-based incentive payment system (MIPS) should be a snap in 2018. CMS made minimal changes to the program this year, which will free clinicians to concentrate on improvement activities or explore options such as virtual groups.

In a course reversal, CMS announced that the cost performance category will account for 10% of a clinician’s score under the merit-based incentive payment system (MIPS) starting in 2018, according to the 2018 Quality Payment Program final rule released Nov. 2.

New “virtual groups,” which let solo practitioners and members of disparate small practices band together to report measures for the merit-based incentive payment system (MIPS), were finalized in close to the same form that was laid out in the Quality Payment Program (QPP) proposed rule. But the short deadline, as well as several issues that CMS plans to address in the future, suggest the first year of this innovation will be tough sledding.

You’ll find a small payment increase in 2018 for several frequently reported E/M codes, including a 1% jump for office code 99214, which brings the non-facility payment rate to $109.44 per encounter — up a smidge from the 2017 rate of $108.74.

Check out our comprehensive breakdown of changes in the 2018 Medicare physician fee schedule final rule.