Many medical providers have not begun preparing for Medicare’s Physician Quality Report System (PQRS) reporting in 2013. Any provider who does not meet the minimum reporting requirements for PQRS in 2013 will be penalized 1.5% of their Medicare payments in 2015.

Physician Quality Report System

Physician Quality Report System

This penalty increases to 2.0% in 2016 if they fail to report successfully in 2014. Providers who are successful at PQRS reporting in 2013 and 2014 will receive a 0.5% incentive payment from Medicare for each of those years.

If you and your practice have not started preparations for PQRS yet, you need to start now. The first step is selecting which of the 264 individual measures you want to report on for 2013. You must report on a minimum of 3 measures for your Medicare Part B FFS patients in 2013. Then you need to decide which way you want to report to Medicare on the chosen measures, either claims based or registry based reporting. Claims based reporting requires you to report on 50% of your eligible Medicare Part B FFS patients for the year, with registry based reporting requiring you to report on 80% of your eligible Medicare Part B FFS patients for the year.

The next step is determining if there are procedures in your office that need to be changed in order to successfully collect and report on your chosen PQRS measures. This may include updating your forms that the patient completes, asking specific measure related questions when you are assessing the patient making sure to documenting it in the patient’s medical record and updating your superbill/charge slip to include the PQRS measures numerator codes to report to Medicare.

Superior Medical Billing Solutions can help you navigate PQRS by advising you on measures that you can report on, helping you decide if claims based or registry based reporting is right for you and helping you audit to make sure you are reporting on enough measures and patients to avoid the penalties in 2015. Give us a call today to start on your way to being a successful PQRS reporter.