2018 QPP Reporting

2018 QPP Reporting

We are now entering year two of QPP reporting and there are some changes.

Since 2017 was considered a “Transition Year”, CMS reduced the reporting requirements to help transition
EP’s (eligible professional) into the new QPP program. 2018 reporting requirements will be more
comprehensive, and the biggest change for qualified EP’s is that CMS has extended the reporting period to
include the entire year.

What is the first step? Check to see if you are exempt from reporting. The Low Volume Threshold Exemption
for 2018 has increased. A practice that is less than $90,000 in Medicare-Allowed Charges or less than 200 Medicare patients is not required to report QPP. Per CMS the following link will be updated February 1 with 2018 exemptions. They will be sending out letters to those exempt on January 22 via the facility where you practice. You can also call RCM’s QPP authority – Pattie Parker at 714.347.1020.


If your volume requires you to report, what do you need to do to avoid a negative payment adjustment of 5%
or possibly earn a positive adjustment in 2020?

You must achieve a minimum composite score of 15 points by doing the following:

  • Successfully report the 60% data completeness threshold for 6 Quality Measures (if possible)
  • Satisfy the reporting requirements of the improvement Activities Category

Quality Measures

The same Quality Measures that were reported in 2017 will roll into 2018 with the addition of one new
Pediatric PONV Measure 463. 2018 has 8 measures available for anesthesiologists to report and if you do any
type of Patient Facing – Evaluation & Management services you have an additional 2 that must be reported.

Of the 6 Quality Measures CMS requires anesthesiologists to report, one must be an outcome measure, if
available or one high priority measure. It is important that you review the Quality Measures and report all
applicable measures to reach the threshold for 2018 reporting.

Patient Facing (E & M Codes) must also report the following measures:

Number Description Measure Classification
Measure 44 Beta Blockers Process
Measure 76 Sterile Barrier Process
Measure 404 Smoking Abstinencer Intermediate Outcome
Measure 424 Temperature Management Outcome
Measure 426 Transfer to PACU Process
Measure 430 Adult PONV Process
Measure 463 Pediatric PONV Process
Measure 47 Advanced Care Plan Process
Measure 130 Medication List Process

Improvement Activities
A new category that EP’s are still getting familiar with is “Improvement Activities”. These activities are steps EP’s can do to improve their practice. For EP’s considered to be non-patient facing the requirement is 1 high weighted or 2 medium weighted improvement activities. This part of the QPP reporting is being finalized by CMS and further information on how to report these through an attestation will be sent when it is made available by CMS.

All this information may seem overwhelming at first but RCM is here to guide you through it. RCM is continuing to be a Qualified CMS Registry for 2018 reporting. We will regularly monitor your reporting and give you feedback as we find necessary to help you meet the requirements for successful reporting.

The following link to CMS can give you more detailed information on all aspects of 2018 MIPS/QPP