Telehealth Encounters and 2020 MIPS eCQM Reporting

Telehealth Encounters and 2020 MIPS eCQM Reporting

Dear Valued Clients:

CMS has released new guidance on telehealth encounters for eligible clinicians who submit MIPS data using eCQMs for the 2020 performance period.  The telehealth guidance document is available on the eCQI Resource Center for Eligible Clinicians under the 2020 Reporting/Performance Year.

CMS’s guidance on telehealth encounters includes an updated list of eCQMs that are not eligible for telehealth encounters.  Based on CMS’s list, gGastro® Measure, CMS69v8 – Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan, are not eligible for telehealth encounters.

How does this update affect you?

Due to this CMS update, telehealth encounters will need to be excluded from the denominator of CMS69 prior to submitting your 2020 MIPS Quality Data.

We recommend that you use one of the two options outlined below to identify telehealth encounters that should be excluded from the denominator for the measure.  In addition, please note that if you are planning to report Measure CMS69, you must have updated to gGastro® Version 4.72.1, planned for release in October, prior to reporting your 2020 Quality Reporting.

How does gGastro identify telehealth encounters?

gGastro is currently configured to exclude from the denominator for CMS69 all encounters to which modifier 95, which is the modifier CMS indicated should be used for telehealth encounters during the COVID-19 public health emergency, has been appended in the E/M Coding screen.

If you have consistently used modifier 95 to identify telehealth encounters since January 1, 2020, no further action is required, as the system will automatically exclude such encounters from the denominator for this measure.  However, if you have not consistently used modifier 95, gGastro v. 4.72.1 (currently planned for release in October 2020) will include a new functionality to enable you to identify relevant encounters as being conducted via telehealth, even if modifier 95 was not used.

Specifically this new functionality will offer a checkbox on the Checkout Screen that users can use to manually flag an encounter as telehealth.  If you have not consistently used modifier 95 with respect to telehealth encounters, please review your historical visits and select this checkbox for all visits that occurred via telehealth to ensure that they are appropriately excluded from the denominator for CMS65.

Please note that telehealth encounters will need to be identified and excluded prior to reporting 2020 MIPS Quality Measures.

Modernizing Medicine Gastroenterology is committed to helping you maintain the highest standards in MIPS submission.  We hope this update is helpful to you in your preparations.



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