What is pqrs incentive

Reporting for the Physician Quality Reporting System is not intended to be complicated or time consuming. You will add a few codes to the electronic or paper claim form that you currently submit to Medicare. More detailed information is available on the CMS website.

Information is also available from your local Medicare carrier. During the initial reporting period that started on July 1, , psychologists had limited opportunity to participate in the former PQRI program, as there was only one measure for mental health.

The measure focused on patients suffering from major depressive disorder that had been prescribed, or at least evaluated for, the use of antidepressant medication. Several new measures have since been developed.

For , psychologists have 11 measures available for claims-based reporting in PQRS, and two available for registry reporting:. In addition, a new measures group for dementia has been created that can only be reported through a registry PDF, 44KB due to the way in which the measures must be analyzed. This measure is not limited to only the health care professional who prescribed the antidepressant medication. If you are reporting through a registry and providing psychotherapy to a patient who suffers from depression and is taking antidepressant medication prescribed by a physician, you can report the measure.

You must be enrolled as a Medicare provider under the clinical psychologist designation and have a national provider identifier NPI number. As of Jan. Eligible professionals either as individuals or as a group practice may satisfy the requirements for PQRS by reporting quality measures data to a participating registry.

A number of different vendors have created registries that collect and transmit the data to CMS. PQRS registries must meet criteria set by CMS such as having secure methods for data transmission and providing feedback to registry participants. No, but you should not take too long to decide. Because you must report on 50 percent of the applicable cases during the month reporting period, failure to start early could prevent you from reaching this threshold and make you ineligible for the bonus payment.

CMS has eliminated the 6-month reporting period for individual measures reported through claims or a registry. For , individual claims should be submitted for a month reporting period. Those for whom fewer than nine measures across three domains apply could still qualify for the bonus. If a psychologist reports on one to eight measures, or nine measures across fewer than three domains, their claims will automatically be reviewed by CMS under the Measure Validation Process MAV so that CMS can determine if additional measures should have been reported.

Eligible professionals who fail MAV will not earn the PQRS incentive payment for and may be subject to the payment adjustment. Readers might be surprised to find out that despite the cost intensity including time requirements personnel, the negative payment adjustments, are only the tip of the iceberg of cost.

Indeed, all of the above may only be one-third or one-fourth of the cost to completely implement the PQRS system. In addition, penalties for lack of reporting of PQRS measures stands to be controversial to the Supreme Court ruling that unfunded mandates must not be permitted and also lack of significant relationships with improvement in quality in the overall analysis in multiple publications.

When this occurs, the only CMS-approved mechanism for reporting is claims-based reporting. Claims-based reporting must be completed using a 50 percent sample of applicable Medicare Part B fee for service patients.

If CMS finds an additional measure could have been reported, the EP will not qualify for an incentive payment. EPs can avoid payment adjustments in by reporting one valid measure, on one patient, one time in This must be done using the claims-based reporting mechanism.

Measures Group: Report one 1 measure group per eligible professional for a 20 patient sample. The table below is a composite of measures that several SNMMI members have identified as applicable to the nuclear medicine community.