News & Press: Quality Improvement

New Information Available to Clarify CMS “Special Status” Calculation

Friday, August 11, 2017  

The U.S. Centers for Medicare & Medicaid Services (CMS) has introduced new information to clarify its “special status” calculation. To determine if a clinician’s participation should be considered special status under the Quality Payment Program, CMS retrieves and analyzes Medicare Part B claims data. Calculations are run to indicate a circumstance of the clinician's practice for  which special rules would apply. These circumstances are applicable for clinicians in: Health Professional Shortage Area (HPSA), rural, non-patient facing, hospital-based, and small practices.

Special status affects the number of total measures, activities, or entire categories that an individual clinician or group must report. Individual clinicians or groups with special status are not exempt from the Quality Payment Program because of their special status determination. CMS recently sent a message incorrectly stating that clinicians considered to have “special status” would be exempt from the Quality Payment Program.

For more information, please visit the CMS Quality Payment Program website.

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