Continuing our Q&A series from our recent webinar on PQRS, we’re answering the rest of the excellent questions from participants that we couldn’t answer in the time available. You can read the first part of this Q&A series now.
Q. Is there an option to avoid penalty only? For a plastic surgery practice, we don’t have all the patient data to meet all measures.
A. For PQRS, use the claim method and report at least 3 measures. “For those EPs who satisfactorily submit quality-data codes (QDCs) for fewer than 9 PQRS measures across 3 domains, a Claims-Based MAV process will determine whether they should have submitted additional measures or domains. For payment adjustment considerations for those EPs who satisfactorily submit QDCs for fewer than 3 PQRS measures, the MAV process will determine whether an EP should have submitted for additional measures.”
It is too late in the year to use the claim method if you plan on starting now. You may choose to use a registry.
Q. I am an internist and a solo practitioner. My EHR does not support PQRS reporting. I am using claim based method. How many measures must I report and on what percentage of patients in order to avoid penalties in 2015?
A. We recommend that you refer to the CMS tip sheet at http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Downloads/2014PQRS_SatisfRprtng-Claims_F11-26-2013.pdf
Q. Do PAs and NPs report for PQRS? PAs did not report for Meaningful Use.
A. Physician Assistants and Nurse Practitioners are eligible for incentive and subject to payment adjustment under PQRS.
NPs were only eligible for the EHR incentive under the Medicaid program. Physician Assistants were eligible for Meaningful Use under the Medicaid EHR Incentive Program only if they are practicing in a Federally Qualified Health Center led by a physician assistant or Rural Health Clinic. See http://www.healthit.gov/policy-researchers-implementers/eligible-professionals-eligible-hospitals for more information
For the Value-Based Modifier (VBM) program, PAs and NPs will be counted as “eligible professionals” for purposed of determining group practice size and VBM application but are not subject to the VBM individually. Note: The VBM will only affect physician payments despite the inclusion of other professionals for purposes of determining group size. See http://www.osteopathic.org/inside-aoa/public-policy/regulatory-issues/Documents/value-based-modifier-policies-faq.pdf for additional information.
Q. As a solo practice psychiatrist Medicare provider, where is the best source of information concerning using claims-based reporting and is this method sufficient to avoid the 2016 penalty? Also, what are the current minimum reporting requirements for psychiatry?
A. For PQRS and Meaningful Use there are no specialty-related mandates. For the EHR method, report any of the 64 measures that your EHR supports.
For additional information, the best place to start is the source: CMS. You can find all of their information at http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/index.html?redirect=/PQRS/ We would also recommend that you check with your specialty society for their advice. In this case, the American Psychiatric Association provides information at http://www.psychiatry.org/practice/managing-a-practice/medicare/physician-quality-reporting-system-pqrs
Q. In Meditouch, do we need to use a G code while billing to get credit for eRX? Or does the system do this for us?
A. There is no eRX incentive program at this time. Please check with Customer Support if you are referring to a different program, and they can assist you.
Q. We have attested and are starting the PQRS process right now. Are we in the correct time frame?
A. You need a full year of data for PQRS; if you are starting now, we would need to know more about your specific circumstances to offer the proper advice. If you have been using the same EHR for all of 2014 the data for PQRS may be already be ready for “mining” a PQRS compliant file.
Q. Our group has about 12 providers. Can we still report by claims? Or will we be required to report via a registry/EHR?
A. It is too late this year to report by claims if you have not already started. View this tip sheet on group reporting: http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Group_Practice_Reporting_Option.html.
Q. Are PQRS and the data extraction included with Meditouch?
A. Yes, PQRS features and the ability to export a compliant data file are included with MediTouch.
We appreciate the excellent questions submitted by our webinar participants, and again, the informative presentations by Dr. Richard Snow and Dr. Seth Flam. If you missed the webinar, you can view the recording in our Resource Center at your convenience.
Don’t forget to register now for our next webinar, The Value-Based Modifier: What’s the Impact on Your Practice? You won’t want to miss this informative program featuring Dr. Barbara J. Connors, Chief Medical Officer at The Centers for Medicare & Medicaid Services Region III.