42cfr, part 512, sub part g
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Yes, my partner did a non accredited fellowship. He will be our Medicare specialist going forward.
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What is this for? Can you give a couple sentence summary and does it apply to all of us board certified docs
Honestly I don’t completely understand it. It’s only if you’ve been lucky enough to be selected to be part of the program.. it’s from what I can tell a way for them to try and create metrics and then penalize you for not meeting them or your outcomes not being good enough. There is a page where you can look up who has been selected on their website.
I thought they were pretty broad with it. If you’re billing under taxonomy codes for anesthesia, pain management, neurosurgery, orthopedic surgery, PMR, and have 20 or more low back pain patients treated
I'm not seeing you show up in the participant list
It’s a quality improvement measure where they track how much Medicare dollars are being spent on back pain, and they pin the blame on one unlucky doctor
Excellent thanks
I’m not sure where the penalties are spelled out.. they probably withhold payment.
I believe somewhere in there it says they track the midlevel you supervise. So I don’t think you can avoid it that way.
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I assume that means you would get ranked last and your Medicare reimbursements get penalized in 2028 or 2029.
So if you have 4 mid levels do you cost 5x as much as someone who doesn’t
Is this the same thing?
Yes
Has anyone figured out a good way to track or monitor the episodes (EBCMs) via your EMR to monitor episode attribution? I have EClinicalWorks
