Medicare Payments Subject to MIPS Are Being Applied to Part B Drugs in Error

Last Updated: Feb 7, 2019

Claim_computer_keyboard-articleThe Pennsylvania Medical Society (PAMED) has received reports that Medicare payments subject to the Merit-based Incentive Payment System (MIPS) are being applied to Medicare Part B drugs, which is not permitted. The error has been identified and Novitas Solutions, Medicare Administrative Contractor for Pennsylvania, is working to resolve affected claims. 

Physicians will not need to take any further action. If a claim was overpaid, a notification will be sent for recoupment from Novitas Solutions. If a claim was underpaid, an adjustment will be made.

MIPS payment adjustments apply to Medicare Part B covered professional services and are applied to the Medicare payment amount. As per the Bipartisan Budget Act of 2018, adjustments are not applied to Medicare Part B drugs. The beneficiary’s financial responsibility will not be impacted by the payment adjustment.

If you notice any discrepancies, please reach out to the Quality Payment Program hotline at (866) 288-8292 or PAMED’s Practice Support Team for assistance.

PAMED members can contact our Practice Support Team at 855-PAMED4U (855-726-3348) or KnowledgeCenter@pamedsoc.org.


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