PQRS – Don’t leave your money on the table!

Did you know you could still participate in PQRS for 2014 and not only receive your 0.5% reimbursement based on charges for covered services billed in 2014, but also avoid the 2.0% penalty next year? The deadline for reporting is now as late as March 13th with some vendors.

What is PQRS?

A separate incentive program from meaningful use that is available to eligible providers who provide Medicare part B services. Submitting clinical quality measure data associated with meaningful use does not automatically meet the PQRS reporting requirement, even though some of the measures do overlap.

Who qualifies?

Physicians, practitioners and therapists that bill Medicare Part B services. For a full list, go to: http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Downloads/PQRS_List-of-EligibleProfessionals_022813.pdf .

What do you do?

  1. Choose a reporting option: Clinical registry reporting or claims registry reporting. You can access a list of vendors and pricing on the Medicare website: http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Downloads/2014QualifiedRegistries.pdf .
  2. Based on your choice in #1, you may be able to report on a measure group (Asthma, HTN, Low back pain, etc.) versus picking individual measures. This is easier because it involves a 20 patient sample, 11 of which must be Medicare.
  • Measure group – Pick the patient sample based on the measure group you choose, for example, the Preventive Care group is based on a patient sample of 50 years and older with a new or established visit (99201-99205, 99212-99215), so you would pick 20 patient that meet that criteria, 11 of which must be Medicare patients. Then audit those charts against the measures included in that particular measure group.
  • Individual measures – Pick 9 PQRS measures based on the measures supported by the vendor you choose and follow the vendor’s instructions for collecting and submitting the data.

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