CMS reveals 2018 value modifier

CMS revealed more than 20,000 clinicians will receive a positive payment adjustment on their Medicare physician fee schedule payments this year under the 2018 Value Modifier, which is based on quality and cost performance from 2016.

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The 20,481 clinicians who performed highly in providing quality care and keeping costs down will receive an increase of 6.6 to 19.9 percent on their Medicare payments in 2018.

However, the “overwhelming majority of clinicians” will not receive any payment adjustments, according to CMS. Most physicians subject to the value modifier — roughly 750,000 — received a neutral payment adjustment. More than 295,000 clinicians would have received a downward adjustment due to the failure to report quality data, but they were not penalized due to policy changes to the 2018 fee schedule. No practices or clinicians would have received a downward adjustment for poor performance.

This is the final year of the payment adjustment before the Quality Payment Program replaces it in determining physician Medicare payment adjustments.

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