Deadline Extended for Value-Based Payment Modifier Informal Review Request

Practices of ten or more providers in 2014 were subject to the Value-Based Payment Modifier (VBM) in 2014. The Value Based Payment Modifier is a “quality and cost” program. It links directly to the PQRS program and rewards or penalizes providers for the quality and cost of care provided. As with all of the quality / bonus programs, payment adjustments are based on participation two years prior to the year in question.

If you received notification of a 2016 penalty resulting from the 2014 VBM calculation and believe there is an error in the calculation, you may request an informal review. The deadline for the informal review has been extended to December 16, 2015.

Information about the group’s quality and cost reports and how to request a review can be found at this link: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeedbackProgram/2014-QRUR.html