CMS Proposes New MIPS Patient Relationship Code Reporting Process

Medical Billing

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The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) required CMS to develop patient relationship codes to attribute patients and episodes of care to clinicians for purposes of cost measurement in MIPS. Beginning in 2018, clinicians began to voluntarily include patient relationship modifiers on claims to describe their treatment relationship with the patient (i.e., the reporting clinician provides continuous services to the patient and provides principal care; the reporting clinician performs episodic and focused services and provides time-limited care). To incentivize reporting of these codes, CMS proposes a new high-weighted MIPS improvement activity that would award credit to clinicians or group practices that report patient relationship modifiers starting in 2020. For more information, review CMS’ recently released resource on patient relationship code reporting.

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