MACRA Minute – Low-Volume Threshold Determination Periods

Helping you put the MIPS pieces together each week!

Deeper look into the low-volume threshold determination periods for MIPS Eligibility in 2018

From the 2018 MIPS final rule, the low-volume threshold determination period is a 24-month assessment period consisting of:

  • An initial 12-month segment that spans from the last 4 months of the calendar year 2 years prior to the performance period through the first 8 months of the calendar year preceding the performance period; AND
  • A second 12-month segment that spans from the last 4 months of the calendar year 1 year prior to the performance period through the first 8 months of the calendar year performance period. An individual eligible clinician or group that is identified as not exceeding the low-volume threshold during the initial 12-month segment will continue to be excluded under §414.1310(b)(1)(iii) for the applicable year regardless of the results of the second 12-month segment analysis. For the 2019 MIPS payment year, each segment of the low-volume threshold determination period includes a 60-day claims run out. For the 2020 MIPS payment year and future years, each segment of the low-volume threshold determination period includes a 30-day claims run out.

What this means:

Providers have 2 chances to be excluded from MIPS in 2018:

  • If a provider is determined to be below the low-volume threshold in the initial determination period, but they exceed the low-volume threshold in the second period, then they would still be excluded from MIPS.
  • If a provider is found to be above the low-volume threshold in the first determination period, but falls below the low-volume threshold in the second determination period, they would again be excluded from MIPS.

We hope this helps clear up any confusion!

 

Medicaid Providers Reminder:

Alabama Medicaid has extended the deadline for submitting 2017 program year MU attestations for eligible professionals and eligible hospitals to May 15, 2018.

To be considered for an incentive payment, your 2017 MU application must be completely submitted via the Alabama State Level Registry (SLR) by 11:59 p.m. CST on Tues, May 15, 2018.

The Mississippi State Level Registry will be available for Program Year 2017 for Meaningful Use EHR Submissions between February 19 and May 31, 2018. Visit their website to login to the MS State Level Registry.

 

Contact us to find out more about MediSYS and how we can help you: email: sales@medisysinc.com or call 205-631-5969 to schedule a free demonstration.