How will you respond? Will you continue to procrastinate, or will you get on board? For more information, go to www. If you started or will start e-prescribing in , you could receive an incentive bonus of 2 percent of allowed charges if you met the criteria of at least 25 events, with 10 percent of covered services made up of codes identified in the measure denominator. This could be by individual claims, registry, or EHR reporting.
There also is a group practice measure option. You still could meet these criteria by reporting on measures this year, either on an independent e-prescribing system or within your EHR. What are you waiting for? For , you could earn a 1 percent incentive bonus unless you are receiving incentive from the EHR Incentive Program for by claims, qualified registry, or qualified EHR reporting.
There also are proposed options for group practices which are either the same as , or for the pilot group option varying by size.
For , the procrastinators may have an interesting problem. The penalty adjustment is retroactive to your performance in In , you may be subject to a 1 percent payment adjustment unless during the Jan. Even if you received the incentive in , you must meet these criteria to avoid the penalty.
If you are an office-based general practitioner or specialist who sees patients and regularly prescribes medications, you may be subject to this penalty and should act now to plan for Your bottom line will be affected if the proposed rule goes through as written. For more information, see www. Do you have an electronic medical record EMR that meets the meaningful use and certification criteria? Is there a price? Can we decrease our costs by acting sooner? In , Medicare penalties of 1 percent will begin for eligible providers who are not meaningful users of EHR technology.
CMS envisions interconnectivity throughout the nation through a series of provider groups connected to a state Health Information Exchange Program or private health information exchanges that, in turn, connect to the Nationwide Health Information Network.
This could revolutionize medicine through:. These standards will be the only means to transfer medical information electronically. If you are not ready, you will not be able to bill—not only for Medicare, but for other insurances as well. You will not be able to obtain claim status, check patient eligibility, receive your reimbursement notices, enroll in a health plan, or participate in coordination of benefits.
We would like to put this off. AAPC has lobbied to put this off. But it is inevitable, and the timetable has been determined. Begin system implementation and put together a plan for staff training now! It will be in the long run. We will end up with evidence-based care, a value-based purchasing system, more patient safeguards, interconnectivity of information, more precise information, and more efficiency in our practices.
As a contributor you will produce quality content for the business of healthcare, taking the Knowledge Center forward with your knowhow and expertise. Earn CEUs and the respect of your peers. 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. The CMS website contains detailed specification worksheets for each measure.
The best place to start is with your local Medicare contractor. Questions can also be directed to government relations staff for the APA Practice Organization by phone at or by email. While it is true that several of the measures involve patients with MDD, other measures can be used with any diagnosis. For example, measures , documentation of current medications in the medical record, and , elder maltreatment screen and follow-up plan for patients 65 and older , do not require specific diagnoses.
A group is defined as two or more providers who share a common tax identification number TIN and have reassigned their billing rights to that TIN. Psychologists cannot report under PQRS as a group without meeting these requirements. If the practice has signed up to report under the group reporting option, you cannot choose to separately report PQRS measures as an individual because your National Provider Identification NPI number is linked to the TIN used by the group.
If you made no attempt to report any PQRS measures in , there is nothing you can do now about the 1. If, however, you did report on at least one measure in but are now being told that your participation was unsuccessful you have a limited opportunity to request a review. During the period from Jan. The VM is currently being applied only to payments for physicians. Nonphysicians, solo practitioners and small group practices will not be impacted by the VM until What is the Physician Quality Reporting System?
In , the reporting program shifted from a voluntary program to a mandatory one in which penalties were assessed for failure to participate. PQRS ended as a stand-alone program on Dec. Is this a pay-for-performance program? The program has "physician" in the title, so how can psychologists participate?
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