For providers who are required to participate in the federal government's Quality Payment Program, the exemption application is open for the 2023 reporting year. The government is allowing COVID-19 to be the basis for the exemption. Why bother? If you are required to participate in the program based on your Medicare volume, you must either report or apply for the exemption to avoid the 9% penalty on all Medicare reimbursement in 2025. To double check on your participation requirement, go to https://qpp.cms.gov/ and enter your National Provider Identifier (NPI).
To determine if your 2023 Medicare payments are being penalized for Performance Year 2021, ask your billing team to print off a Medicare remittance. If you see the remark code, CARC 237, you are currently being penalized for failure to successfully participate in the QPP - or declare an exemption. (Claims adjustment reason code 237 is used to denote “Legislated/Regulatory Penalty.")
To apply for the exemption, go to: https://qpp.cms.gov/mips/exception-applications. The application deadline for 2023 is 8 p.m. EST on January 2, 2024. The application takes minutes and can save you tens of thousands of dollars in penalties. If you change your mind and decide to report on the appropriate measures, your application is voided. There is no downside to applying, so don't delay.
Elizabeth Woodcock is the founder and principal of Woodcock & Associates. She has focused on medical practice operations and revenue cycle management for more than 25 years. She has led educational sessions for a multitude of national professional associations and specialty societies, and consulted for clients as diverse as a solo orthopaedic surgeon in rural Georgia to the Mayo Clinic. She is author or co-author of 17 best-selling practice management books, to include Mastering Patient Flow and The Physician Billing Process: Avoiding Potholes in the Road to Getting Paid. Elizabeth is a Fellow in the American College of Medical Practice Executives and a Certified Professional Coder. In addition to a Bachelor of Arts from Duke University, she completed a Master of Business Administration in healthcare management from The Wharton School of Business of the University of Pennsylvania. She is currently a doctoral student at the Bloomberg School of Public Health of Johns Hopkins University.
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