Press Release: Ensure Your Future Medicare Payments Under MIPS & MACRA Do Not Decline

For physicians and other providers that bill Medicare Part B

Contact: Paul Katz

SANTA MONICA, CA USA -- PAYMENT/DELIVERY SYSTEM REFORM UPDATE NEWS SERVICE™ -- NOVEMBER 24, 2017: EZ-FHIR ( has released a free online HCC coding tool and iPhone App for all physicians, providers, and their staffs that enable the transition from ICD-10 to CMS-HCC ICD-10. For physician organizations and health systems, EZ-FHIR can work with you to establish HCC Coding Guidelines that will be available to all of your providers in these tools.

Medicare's MACRA and MIPS program for 2018 has added resource use (Cost) measures into the scorecards for physicians and other providers that bill Medicare Part B. The MIPS' scorecard is used by CMS to adjust (+ or -) future-year Medicare fees paid to each physician and provider.

In calendar year 2018, 15% of the MIPS scorecard will be determined from two Cost measures, plus a new Complex Patient measure. In 2019, these measures will account for over 30% of the scorecard value. The Cost and Complex Patient measures depend on accurately reporting each patient's acuity to CMS, using the CMS Hierarchical Condition Categories CMS-HCC system. CMS-HCCs provide the only way to ensure that CMS accounts for the fact that patients you serve are indeed sicker for the MIPS scorecard.

Visit the EZ-FHIR web site ( and scroll down to the Frequently Asked Questions (FAQ) to learn more about CMS-HCCs. Check out our Training Videos, which show you how to register for the online and iPhone HCC tools. These videos also explain how to use the tools to find the right CMS-HCC ICD-10 codes that need to be included on all of your Medicare billing.

CMS-HCC utilizes a subset of ICD-10 diagnosis codes (approximately 8,000 of the total 70,000-plus ICD-10 diagnosis codes) to identify patients falling into one of 79 risk categories. The risk categories in most cases are additive, where patients can have multiple risk factors tied to different categories and the patient risk score is the sum of the risk weights of each relevant HCC risk category, plus a demographic score.

Physicians and other providers need to know how to find and use the appropriate CMS-HCC ICD-10 diagnosis codes to be sure they are getting proper credit for each patient's acuity. Proper coding on bills to Medicare at each patient encounter is vital, as is the inclusion of all relevant CMS-HCC ICD-10 diagnosis codes during an annual wellness visit (using billing service codes G0438, G0439). CMS-HCC ICD-10 codes need to be reported in every year for your patients, even for patients with chronic conditions.

Ready to try EZ-FHIR's HCC Coding Tools? Register today at: