For the Week of October 27, 2014
Is the value-based payment modifier (value modifier) different from the hospital value-based program mentioned in last week’s question?
Yes, the value modifier relates to physicians only.
According to the Centers for Medicare & Medicaid Services, the Affordable Care Act required Medicare to establish a value modifier that provides for differential payment to a physician or group of physicians under the Medicare Physician Fee Schedule (PFS)—and only under the MPFS—based upon the quality of care furnished to Medicare beneficiaries compared to the cost of that care during a performance period.
The statute also requires that CMS begin applying the value modifier to physicians in groups with 100 or more eligible professionals (EPs) on January 1, 2015, and complete the transition no later than January 1, 2017.
To view and archive of the General Compliance Question of the Week, click here