The Centers for Medicare and Medicaid Services (“Medicare”) is required by statute to collect information on the level of post-operative visits, including the time, staff, and resources involved in furnishing post-operative visits. Medicare is required to use this information to improve the accuracy of payment rates for surgical services. The RAND Corporation and NORC at the University of Chicago are non-profit research organizations that are collecting this information on Medicare’s behalf.

Medicare is sponsoring this data collection effort. The Medicare statute requires the program to collect data on post-operative visits from a representative sample of physicians, and to use this information to improve the accuracy of payment rates for surgical services. Click here to view a letter from Medicare outlining expectations for participation. The RAND Corporation and NORC at the University of Chicago are non-profit research organizations that are collecting this information on Medicare’s behalf.

As a physician who participates in Medicare, you are required to provide information about post-operative care surrounding five post-operative visits that are included in the global period.

You will be asked about post-operative care related to one of three specific CPT codes or sets of codes, depending on your specialty:

• CPT codes 13100, 13101, 13120, 13121, 13131, 13132, 13151, and 13152 (complex repair procedures)
• CPT code 27130 (total hip arthroplasty)
• CPT code 66984 (cataract surgery)

You will be asked about post-operative care centered on five post-operative visits included in the global period, including:

• Date and location of the post-operative visit
• Staff and resources used for the visit
• Which activities were performed during the visit, as well as in between visits

You will be asked a short set of questions about your case mix, and then assigned a total of five office and/or inpatient visits based on your responses. You can see an example of a completed office visit here and a completed inpatient visit here.

You will also be asked a short set of questions about your practice. An example of the completed practice visit questions can be found here.

Reporting this information about post-operative care is done entirely over the Internet, and we recommend that office or clinical staff assist you.

• You will need to reference your (or the physician’s) email received from CMS MACRA_Global_Surgery@cms.hhs.gov for your personalized link
• You will also need your (or the physician’s) National Provider Identifier (NPI), a 10-digit identification number CMS issues to healthcare providers.
  • To find your NPI, please visit https://npiregistry.cms.hhs.gov
• If you experience technical issues, please call 1-888-246-9504 or email MedicarePostopData@norc.org

We ask you to report on five post-operative visits that you furnished during the global period. These visits may be a mix of office-based and inpatient-based visits depending on the case mix you describe in answer to an earlier question.

Office-based visits - These visits can be office-based or other outpatient visits and include visits in the physician office, hospital outpatient department, ED, or other ambulatory setting. Hospital outpatient department and ED visits visits are included in this category, even though they take place at a hospital.

Inpatient visits - Include visits in the inpatient floor, ICU, and long-term care facility settings. Please do not include hospital outpatient department visits or ED visits.

A navigation screen will clearly label office and inpatient visits. After you report on your first visit, please continue to report on either (1) consecutive visits (during your clinic session or inpatient rounds, for example), or (2) every second or third visit, until you have completed five visits. Regardless of your choice, we are asking you to report on visits as they happen over the course of your days(s), not visits over a particular patient’s post-operative course.

• Please report only on visits that fall within the global period for the procedure. These are visits that you should not otherwise bill separately because they are part of a global period.
• You may report on visits during the global period that take place starting the day of the procedure after the patient has left the recovery room.
• Report on visits regardless of payer for the procedure (i.e., do not restrict only to visits following procedures paid for by Medicare).
• Only report on visits where you personally saw the patient.
• Do not include pre-operative visits.

Please report on visits regardless of payer for the procedure (i.e., do not restrict only to visits following procedures paid for by Medicare). If you do not anticipate having a total of five post-operative visits to report on between Thursday, 11/8/2018 and 12/31/2018, only then report on any visits prior to November 8. If you still will not have a total of five post-operative visits, please report on all possible visits and contact NORC at MedicarePostOpData@norc.org. Please include that you do not anticipate having a total of five post-operative visits (regardless of payer or reporting period) and they can record your response as complete.

Please start at your earliest convenience and complete by Monday, December 31st.

If you see a patient multiple times in the same day, please report all of the activities and resources you used on that calendar day as a single “visit”. Do not report two or more separate visits for the same patient on the same day.

Yes. While you may choose to report this information on your own, we recommend that clinical or support staff in your practice (e.g. billing/coding staff, practice manager, medical assistant, nurse, etc.) assist you. However, we ask that you personally report on information related to the time you spent with the patient.

You were selected based on the number of relevant Medicare procedures with global periods that you performed last year and to serve as a representative for your specialty. Your participation is critical to the success of this data collection effort.

We estimate that it will take about five minutes to report on each of the five post-operative visits.

You may also be asked a short set of questions regarding your practice, which is estimated to take no more than 5-8 minutes to complete.

Post-operative visits are included as part of the payment for procedures that have a global period. Inaccurate information about post-operative visits may result in misvalued payments, which could lead to over- or under-payment to physicians like you. Medicare is required by law to collect data on the time, staff, and resources involved in furnishing post-operative visits.

• If you experience technical issues, please call 1-888-246-9504 or email MedicarePostopData@norc.org.
• If you have any questions about this study you can contact the RAND Project Director, Andrew Mulcahy, at 703-413-1100, x 5496 or CMS Technical Advisor, Kathy Bryant, at 1-571-589-8413.
• If you have questions about your rights as a participant, you may call the NORC Institutional Review Board Administrator (toll-free) at 1-866-309-0542.

Yes. These FAQs are available at https://a4survey.norc.org/Global_FAQ or by clicking on the FAQ hyperlink at the bottom of each screen. This will open as a separate webpage for your reference.