WELCOME to the inaugural post of my new Blog, in which I will provide documentation and coding tips for the Merit-based Incentive Payment System (MIPS) Value Pathways (MVP).
MVPs are the newest MIPS reporting option [an alternative to “traditional MIPS” and “Alternative Payment Model (APM) Performance Pathway (APP)”] that clinicians can use to meet their MIPS reporting requirements. Each MVP includes a subset of measures and activities that are related to a given specialty or medical condition.
Leaders at the Centers for Medicare and Medicaid Services (CMS) heard that there is too much choice and complexity when clinicians are selecting and reporting measures and activities in traditional MIPS, causing an increase in administrative burden. With a reduced list of measures and activities to choose from in each MVP, there are fewer options that should create deeper measure and activity links and less administrative burden.
MVP reporting isn’t currently mandatory but CMS intends to sunset traditional MIPS through rulemaking in the future, at which point MVPs will become mandatory unless the clinician is eligible to report the APP. CMS encourages the early adoption of reporting MVPs to allow clinicians to get comfortable reporting MVPs and preparing for any potential practice workflow changes.
For the 2023 performance year, clinicians can choose to report an MVP in addition to another reporting option, such as traditional MIPS or the APP, and CMS will take the highest score that the clinician receives. To report an MVP in performance year 2023, clinicians will need to register between April 1 and November 30, 2023. A detailed registration guide will be available in early 2023 detailing step-by-step instructions for completing the MVP registration process.
Clinicians can indicate their intent to register for a specific MVP or to be scored based on the quality measures within a specialty measure set, by reporting one of the Health Care Common Procedure Coding System (HCPCS) Level II codes below. These codes are not billable services and should remain on the claim form for measurement purposes only.
| HCPCS Code | Code Description |
|---|---|
| G0053 | Advancing Rheumatology Patient Care MIPS Value Pathways |
| G0054 | Coordinating Stroke Care to Promote Prevention and Cultivate Positive Outcomes MIPS Value Pathways |
| G0055 | Advancing Care for Heart Disease MIPS Value Pathways |
| G0056 | Optimizing Chronic Disease Management MIPS Value Pathways |
| G0057 | Proposed Adopting Best Practices and Promoting Patient Safety within Emergency Medicine MIPS Value Pathways |
| G0058 | Improving Care for Lower Extremity Joint Repair MIPS Value Pathways |
| G0059 | Patient Safety and Support of Positive Experiences with Anesthesia MIPS Value Pathways |
| G0060 | Allergy/Immunology MIPS Specialty Set |
| G0061 | Anesthesiology MIPS Specialty Set |
| G0062 | Audiology MIPS Specialty Set |
| G0063 | Cardiology MIPS Specialty Set |
| G0064 | Certified Nurse Midwife MIPS Specialty Set |
| G0065 | Chiropractic Medicine MIPS Specialty Set |
| G0066 | Clinical Social Work MIPS Specialty Set |
| G0067 | Dentistry MIPS Specialty Set |
| G4000 | Dermatology MIPS Specialty Set |
| G4001 | Diagnostic Radiology MIPS Specialty Set |
| G4002 | Electrophysiology Cardiac Specialist MIPS Specialty Set |
| G4003 | Emergency Medicine MIPS Specialty Set |
| G4004 | Endocrinology MIPS Specialty Set |
| G4005 | Family Medicine MIPS Specialty Set |
| G4006 | Gastro-enterology MIPS Specialty Set |
| G4007 | General Surgery MIPS Specialty Set |
| G4008 | Geriatrics MIPS Specialty Set |
| G4009 | Hospitalists MIPS Specialty Set |
| G4010 | Infectious Disease MIPS Specialty Set |
| G4011 | Internal Medicine MIPS Specialty Set |
| G4012 | Interventional Radiology MIPS Specialty Set |
| G4013 | Mental/Behavioral Health MIPS Specialty Set |
| G4014 | Nephrology MIPS Specialty Set |
| G4015 | Neurology MIPS Specialty Set |
| G4016 | Neurosurgical MIPS Specialty Set |
| G4017 | Nutrition/Dietician MIPS Specialty Set |
| G4018 | Obstetrics/Gynecology MIPS Specialty Set |
| G4019 | Oncology/Hematology MIPS Specialty Set |
| G4020 | Ophthalmology MIPS Specialty Set |
| G4021 | Orthopedic Surgery MIPS Specialty Set |
| G4022 | Otolaryngology MIPS Specialty Set |
| G4023 | Pathology MIPS Specialty Set |
| G4024 | Pediatrics MIPS Specialty Set |
| G4025 | Physical Medicine MIPS Specialty Set |
| G4026 | Physical Therapy/Occupational Therapy MIPS Specialty Set |
| G4027 | Plastic Surgery MIPS Specialty Set |
| G4028 | Podiatry MIPS Specialty Set |
| G4029 | Preventive Medicine MIPS Specialty Set |
| G4030 | Pulmonology MIPS Specialty Set |
| G4031 | Radiation Oncology MIPS Specialty Set |
| G4032 | Rheumatology MIPS Specialty Set |
| G4033 | Skilled Nursing Facility MIPS Specialty Set |
| G4034 | Speech Language Pathology MIPS Specialty Set |
| G4035 | Thoracic Surgery MIPS Specialty Set |
| G4036 | Urgent Care MIPS Specialty Set |
| G4037 | Urology MIPS Specialty Set |
| G4038 | Vascular Surgery MIPS Specialty Set |
For more information about these HCPCS codes, see Medicare Transmittal #11578 at https://www.cms.gov/files/document/r11578otn.pdf and/or contact LolitaMJ@iQueryData.com.