2022 Quality Measures for Anesthesia
The 2022 FR provides details on how the Merit-based Incentive Payment System (MIPS), MIPS Value Pathways (MVPs), Alternative Payment Models (APMs) and other features of the Quality Payment Program (QPP) will operate during the 2022 performance year and beyond.
According to the ASA, CMS finalized the anesthesiology MVP for the 2023 reporting year. In 2022, QPP participants will see some modifications to the program, including:
- The MIPS performance threshold will be set at 75 points with an exceptional performance bonus applied to those individuals and groups scoring over 89 points. Individuals and groups receiving less than 75 points will incur a payment penalty on a sliding scale up to 9 percent in 2024, with those scoring under 18.75 points incurring an automatic -9 percent adjustment.
- The quality and cost performance categories will be equally weighted at 30 percent of the total MIPS score. Promoting interoperability and Improvement Activities performance categories will maintain their respective 25 percent and 15 percent weights, respectively.
- The MIPS #44 measure (Coronary Artery Bypass Graft (CABG) – Preoperative Beta-Blocker in Patients with Isolated CABG Surgery) will be retired from the MIPS program.
- The PSH Care Coordination improvement activity is now a “High” weighted improvement activity. The ASA asserts that this designation will reduce group burden on reporting improvement activities by half.
Interestingly, CMS did not finalize its proposal to increase the completeness threshold to 80 percent in the MIPS Quality performance category in 2023 as previously proposed. Instead, CMS will maintain a completeness of 70 percent for the next two years. ASA expects to update its Quality Payment Program website in the next few weeks with regulatory information and the Anesthesia Quality Institute expects to publish its 2022 QCDR measures book by mid-December as well. CMS expects to publish the 2022 MIPS measure specifications and other regulatory guidance within the next few weeks on the QPP website.
Anesthesia Conversion Factor (CF) rose 0.27 percent to $22.27 from $22.19 in 2018
The Centers for Medicare and Medicaid Services (CMS) has published the 2019 Physician Fee Schedule (PFS) final rule detailing, among other things, how anesthesia practitioners will be paid in the coming year and how their participation in Year 3 of the Quality Payment Program (QPP) could impact their payment in 2021.
The national anesthesia conversion factor (CF) rose 0.27 percent to $22.27 from $22.19 in 2018, reflecting anesthesia-specific resource costs related to practice expenses and malpractice insurance. This CF represents the national average. The table here shows the 2018 and 2019 anesthesia CFs by location.*
The non-anesthesia CF also rose slightly from $35.99 to $36.04, representing a 0.25 percent adjustment as mandated by the Bipartisan Budget Act of 2018 as well as a negative 0.14 percent adjustment in keeping with the law’s budget neutrality requirements. Anesthesiologists would use this CF to bill for flat fee services, such as the use of ultrasound guidance and nerve block placement.
As proposed, the work relative value unit (RVU) (one of the three components used to determine fees) for CPT code 95970 (Electronic analysis of implanted neurostimulator pulse generator/transmitter) was reduced from 0.45 to 0.35 for 2019.
Some changes in documentation requirements for E&M services designed to ease administrative burden for clinicians will be implemented in 2019. We are analyzing these changes and will discuss them in a future eAlert. We will also discuss the implications for anesthesia and pain management providers of the significant expansion of payment for telehealth services that became policy with the final rule.
