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Description

As discussed above regarding the expanded policy for reporting transfer of care modifier -54, the new G-code, HCPCS code G0559, is a mechanism to account for practice patterns that are already happening where practitioners are spending time and resources with patients who are seen for a post-operative visit and to ensure those practice patterns are accurately reflected in coding and payment policy

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In response to the proposal in the CY 2023 PFS proposed rule to increase the data completeness criteria threshold to at least 80 percent starting with the CY 2026 performance period/2028 MIPS payment year, interested parties indicated in the public comments that increasing the data completeness threshold from 75 to 80 percent within two years of increasing the threshold from 70 to 75 percent would present various challenges such as the following, which would make it more difficult to meet the data completeness criteria threshold: increased burden (in particular, disproportionately increase burden for smaller and rural practices due to limited resources and staff, and some practices that are continuing to recover from the COVID-19 Public Health Emergency)

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