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PQRS for Medicare

Writer: Bryan JoynerBryan Joyner

PQRS for Medicare.If you're still trying to figure it out, CALL US TODAY.

It's SIMPLE. If you're using Document Plus you've probably even been documenting it. Now you just need to make sure you're reporting it properly.

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What is PQRS?

PQRS stands for the Physician Quality Reporting System. The program was originally established by CMS/Medicare as a "voluntary" program to report quality measures. While the program does offer incentives for participation, it will begin penalizing those who do not report via reduction of their allowable service charges under Medicare. Unsuccessful reporting of assigned quality measures in 2013 will result in a decrease beginning in 2015, and unsuccessful reporting in 2014 will result in a decrease in 2016. The program becomes mandatory in 2015.

Incentives and Penalties

Prior to 2015, successful performance and satisfactory reporting will be incentivized by a 0.5% "bonus" payment of all eligible Medicare services rendered during the calendar year. Failure to successfully and satisfactorily participate in 2013 will result in a 1.5% reduction in Medicare reimbursement beginning in 2015. Continued failure will result in a 2.0% reduction of the Medicare reimbursement rates in 2016.

There are THREE Quality Reporting Measures for Chiropractic for 2014

  • Quality Measure #131: Pain Assessment and Follow Up

  • Quality Measure #182: Functional Outcome Assessment and Follow Up

  • Quality Measure #317: Preventive Care and Screening-Screening for High Blood Pressure and Follow Up

Specific "G-Codes" supplied by Medicare are being used to report measures assigned for chiropractors to track in 2014. Those codes MUST be reported on the claim form, appearing just as a procedural service line item, but including no charge.

CALL TODAY to schedule a short PQRS training session!

 
 
 
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