News & Insights

It's here! Your guide to 2020 payment rules & MIPS requirements

Washington Connection

Medicare Payment Policies

Quality Payment Program

November 20, 2019: The Centers for Medicare & Medicaid Services (CMS) released the final 2020 Physician Fee Schedule (PFS), which includes payment updates for Medicare services, changes to billing guidance for certain codes, and modifications to reporting requirements under the Merit-based Incentive Payment System (MIPS).

MGMA Government Affairs reviewed, analyzed, and distilled this nearly 2,500-page final rule in a member-benefit analysis. The resource breaks down significant payment and quality reporting changes for 2020 and offers practical takeaways for busy medical group practice executives. Key regulatory provisions include:
  • The CY 2020 PFS conversion factor remains relatively flat at $36.0896. The CY 2020 national average anesthesia conversion factor will be $22.2016.
  • In 2021, CMS will maintain separate payment rates for E/M office visits, delete level 1 office visits for new patients, and increase the payment rate for E/M services. 
  • Payment rates for transitional care management services will increase in CY 2020.
  • The MIPS score to avoid a negative payment adjustment in 2022 will increase to 45 points based on performance in 2020.
Download MGMA's member exclusive analysis.

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