On October 14, the Centers for Medicare & Medicaid Services (CMS) released the highly-anticipated Final Rule implementing the Medicare physician payment reforms enacted as part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). 

Here are the four options qualifying providers may select from in order to begin participating for the first performance period, scheduled to begin January 1, 2017. Selecting an option is important to ensure that a practitioner is not penalized in 2019.

While the first year for the Medicare Access and CHIP Reauthorization Act is 2019, the performance period is 2017 (unless modified in the final rule). Thus, performance in 2017 will determine payment adjustments in 2019.