Merit-based Incentive Payment System Value Pathways (MVP) Documentation & Coding Tips:

2023 Updates to the HCPCS Codes for MIPS Specialty Sets and MVPs

Lolita M. Jones, MSHS, RHIA, CCS, CRC
Posted on:
By:
Lolita M. Jones, MSHS, RHIA, CCS, CRC

The Calendar Year 2023 Medicare Physician Fee Schedule Final Rule finalized the following new Merit-based Incentive Payment System (MIPS) Value Pathways (MVPs) that are now available to report beginning with the 2023 performance year:

  • Advancing Cancer Care
  • Optimal Care for Kidney Health
  • Optimal Care for Patients with Episodic Neurological Conditions
  • Supportive Care for Neurodegenerative Conditions
  • Promoting Wellness.

Clinicians can indicate their intent to register for any of the new MVPs, or to be scored based on the quality measures within a specialty measure set, by reporting one of the new Health Care Common Procedure Coding System (HCPCS) Level II codes below.  These codes – which are effective January 1, 2023 – are not billable services and should remain on the claim form for measurement purposes only:

M0001                 Advancing Cancer Care MIPS Value Pathways

M0002                 Optimal Care for Kidney Health MIPS Value Pathways

M0003                 Optimal Care for Patients with Episodic Neurological Conditions MIPS Value Pathways

M0004                 Supportive Care for Neurodegenerative Conditions MIPS Value Pathways

M0005                 Promoting Wellness MIPS Value Pathways.

Also effective on January 1, 2023, are revisions to two pre-existing MIPS Specialty Set HCPCS Level II codes, both of which now include a new specialty (see underlined text below):

G4013                  Mental/Behavioral Health and Psychiatry MIPS Specialty Set

G4020                  Ophthalmology/Optometry MIPS Specialty Set.

A complete listing of all 2023 HCPCS Level II Codes for MIPS Specialty Sets and MVPs appears below:

HCPCS CodeCode Description
G0053Advancing Rheumatology Patient Care MIPS Value Pathways
G0054Coordinating Stroke Care to Promote Prevention and Cultivate Positive Outcomes MIPS Value Pathways
G0055Advancing Care for Heart Disease MIPS Value Pathways
G0056Optimizing Chronic Disease Management MIPS Value Pathways
G0057Proposed Adopting Best Practices and Promoting Patient Safety within Emergency Medicine MIPS Value Pathways
G0058Improving Care for Lower Extremity Joint Repair MIPS Value Pathways
G0059Patient Safety and Support of Positive Experiences with Anesthesia MIPS Value Pathways
G0060Allergy/Immunology MIPS Specialty Set
G0061Anesthesiology MIPS Specialty Set
G0062Audiology MIPS Specialty Set
G0063Cardiology MIPS Specialty Set
G0064Certified Nurse Midwife MIPS Specialty Set
G0065Chiropractic Medicine MIPS Specialty Set
G0066Clinical Social Work MIPS Specialty Set
G0067Dentistry MIPS Specialty Set
G4000Dermatology MIPS Specialty Set
G4001Diagnostic Radiology MIPS Specialty Set
G4002Electrophysiology Cardiac Specialist MIPS Specialty Set
G4003Emergency Medicine MIPS Specialty Set
G4004Endocrinology MIPS Specialty Set
G4005Family Medicine MIPS Specialty Set
G4006Gastro-enterology MIPS Specialty Set
G4007General Surgery MIPS Specialty Set
G4008Geriatrics MIPS Specialty Set
G4009Hospitalists MIPS Specialty Set
G4010Infectious Disease MIPS Specialty Set
G4011Internal Medicine MIPS Specialty Set
G4012Interventional Radiology MIPS Specialty Set
G4013Mental/Behavioral and Psychiatry MIPS Specialty Set
G4014Nephrology MIPS Specialty Set
G4015Neurology MIPS Specialty Set
G4016Neurosurgical MIPS Specialty Set
G4017Nutrition/Dietician MIPS Specialty Set
G4018Obstetrics/Gynecology MIPS Specialty Set
G4019Oncology/Hematology MIPS Specialty Set
G4020Ophthalmology/Optometry MIPS Specialty Set
G4021Orthopedic Surgery MIPS Specialty Set
G4022Otolaryngology MIPS Specialty Set
G4023Pathology MIPS Specialty Set
G4024Pediatrics MIPS Specialty Set
G4025Physical Medicine MIPS Specialty Set
G4026Physical Therapy/Occupational Therapy MIPS Specialty Set
G4027Plastic Surgery MIPS Specialty Set
G4028Podiatry MIPS Specialty Set
G4029Preventive Medicine MIPS Specialty Set
G4030Pulmonology MIPS Specialty Set
G4031Radiation Oncology MIPS Specialty Set
G4032Rheumatology MIPS Specialty Set
G4033Skilled Nursing Facility MIPS Specialty Set
G4034Speech Language Pathology MIPS Specialty Set
G4035Thoracic Surgery MIPS Specialty Set
G4036Urgent Care MIPS Specialty Set
G4037Urology MIPS Specialty Set
G4038Vascular Surgery MIPS Specialty Set
M0001Advancing Cancer Care MIPS Value Pathways
M0002Optimal Care for Kidney Health MIPS Value Pathways
M0003Optimal Care for Patients with Episodic Neurological Conditions MIPS Value Pathways
M0004Supportive Care for Neurodegenerative Conditions MIPS Value Pathways
M0005Promoting Wellness MIPS Value Pathways

For more information about these HCPCS codes, download and unzip the “January 2023 Alpha-Numeric HCPCS File” at https://www.cms.gov/medicare/coding/hcpcsreleasecodesets/hcpcs-quarterly-update and/or contact LolitaMJ@iQueryData.com.