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Description

Proposed Changes to the Methodology for Calculating the MIPS Quality Performance Category Score for Shared Savings Program ACOs Reporting the APP Plus Quality Measure Set (1) Background Consistent with the authority to establish the quality reporting and other reporting requirements for the Medicare Shared Savings Program set forth in section 1899(b)(3) of the Act and the statutory requirements for the Quality Payment Program set forth in section 1848(q) and (r) of the Act for MIPS and section 1833(z) of the Act for Advanced APMs, since the Shared Savings Program's alignment with the APP in performance year 2021, MIPS eligible clinicians identified on the Participation List or Affiliated Practitioner List of an APM Entity participating in a MIPS APMincluding ACOs that participate in the Medicare Shared Savings Programthat report data via the APP have been scored according to the APP scoring methodology described at 414.1367

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Key documentation elements When assigning the ICD 10 code for cannabis dependence, clinicians should document: Clear criteria supporting dependence (e.g., loss of control, continued use despite harm) Absence of physiological complications like withdrawal Functional consequences attributable to cannabis use Relevant history, including prior use patterns and attempts to reduce or stop Example documentation might describe: Client reports cannabis use daily for 2+ years, unsuccessful efforts to cut down, priority given to use over work obligations, and continued use despite notable academic and interpersonal problems

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(4) Comprehensive Care Management We are proposing for APCM services the Comprehensive Care Management service element we established for CCM and PCM services with some modifications

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