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Summary of the 2019 Medicare Physician Fee Schedule (PFS) Proposed Rule — Quality Provisions

On November 1, 2018, the Centers for Medicare and Medicaid Services (CMS) released the Revisions to Payment Policies under Physician Fee Schedule and Other Revisions to Part B for CY 2019; Medicare Shared Savings Program Requirements final rule with comment period. This is the first year that CMS combined the Medicare PFS and the Quality Payment Program (QPP) proposed rules. The final rule contains some significant changes to Medicare’s physician payment and quality programs, which consists of two participation pathways — the Meritbased Incentive Payment System (MIPS), which measures physicians based on four performance categories, and advanced alternative payment models (APMs) in which clinicians may earn incentive payments based on sufficient participation in these models. CMS has published several fact sheets on the rule, including a 2019 QPP final Rule Executive Summary and a 2019 QPP Final Rule Overview Fact Sheet. Earlier in the year, AANS/CNS expert volunteers on the Neurosurgery Quality Council and staff provided substantive comments on the proposals in this rule. Below is a summary of some of the quality provisions finalized in this regulation. The payment issues summary is separately available.

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