RT Journal Article SR Electronic T1 MACRA 2.5: the legislation moves forward JF Journal of NeuroInterventional Surgery JO J NeuroIntervent Surg FD BMJ Publishing Group Ltd. SP 1224 OP 1228 DO 10.1136/neurintsurg-2018-013910 VO 10 IS 12 A1 Lauren Parks Golding A1 Gregory N Nicola A1 Sameer A Ansari A1 Andrew B Rosenkrantz A1 Ezequiel Silva III A1 Laxmaiah Manchikanti A1 Joshua A Hirsch YR 2018 UL http://jnis.bmj.com/content/10/12/1224.abstract AB The Medicare and CHIP Reauthorization Act of 2015 remains the payment policy law of the land. 2017 was the first year in which performance reporting will tangibly impact future physician payments. The Centers for Medicare & Medicaid Services (CMS) considers 2017 and 2018 transitional years before full implementation in 2019. As such, 2018 increases the reporting requirements over 2017 in the form of a gradual phase-in while introducing several key changes and new elements. Indeed, it is the nature of the transition itself that led to the somewhat unique title of this manuscript, i.e., MACRA 2.5. Stakeholder feedback to the CMS regarding the program has ranged widely from the elimination of core components to expanding reporting to non-government payers. This article explores the potential impact on neurointerventional physicians.