PQRS Reporting: How to Avoid the -2% Payment Adjustment in 2017

ML Medical Billing would like to inform our clients of important PQRS changes for 2015 that will help you avoid the -2% Payment Adjustment in 2017. Our clients who are already registered with PQRS PRO, may fulfill their PQRS reporting requirements by contacting an expert at PQRS PRO. Please keep in mind, PQRS reporting is clinical in nature and cannot be completed by ML Medical Billing.
Important 2015 PQRS Changes You Need to Know:
  • There is no longer an incentive reporting option. All reporting in 2015 is to avoid the -2% Payment Adjustment in 2017 for non-reporting.
  • To report in 2015, a provider must report one Measures Group or 9 individual measures across 3 National Quality Strategy (NQS) domains; at least one of the 9 measures must be a cross-cutting measure (if the EP sees any Medicare patients face-to-face).
PQRSThree Options for Successful Registry Reporting in 2015:
  1. Measures Group: To meet the reporting requirement, enter data from a minimum of 20 unique patient visits, a majority of which (at least 11) must be Medicare Part B Fee-For-Service (FFS) patients. Submitting a measures group successfully will avoid the -2% Payment Adjustment in 2017. Note that measures with a 0% Performance Rate will not count – you must meet the quality action when able, at least once, for the selected measures or measures group to successfully avoid the –2% payment adjustment in 2017. (Note: GPROs cannot report a measures group.)
  2. Individual Measures: Submit at least 50% of your eligible Medicare patient visits for at least 9 individual measures, from at least 3 of the National Quality Strategy (NQS) domains successfully avoids the -2% Payment Adjustment in 2017. Note that measures with a 0% Performance Rate will not count – you must meet the quality action when able at least once for the selected measures or measures group to successfully avoid the –2% payment adjustment in 2017.
  3. Individual MeasuresMeasures Applicability Validation (MAV) Process if your patient population/practice/specialty does not meet the required criteria for reporting 9 individual measures and/or cannot cover 3 NQS domains, your submission will be subject to the CMS Measures Applicability Validation (MAV) process, during which CMS will audit 2015 claims, applying a ‘clinical relation/domain test’ – comparing ‘clusters,’ or sets of closely related measures, to determine whether additional measures and/or domains may have also been applicable. If CMS finds that there are additional measures applicable for the reporting period, you will not avoid the payment adjustment. A CMS Course in the MAV process is available, in addition to a number of other educational resources. Please note: in addition to the MAV cluster reported, at least one cross-cutting measure must be satisfactorily reported for those individual providers or group practices with face-to-face encounters. You can explore the measures and options more fully on the measures pages linked above.
New to PQRS PRO?
For our clients who are not currently registered, PQRS PRO is an online service that walks users through the PQRS measure reporting process. Since 2009, PQRS PRO has been providing an intuitive, user-friendly online PQRS registry reporting software with a success rate of 99.5% and over for thousands of healthcare professionals.Here are the basics:
  • PQRSPRO is cloud-based, secure, and operates via most mobile devices with internet connectivity.
  • PQRSPRO supports all 2015 PQRS registry measures groups and Individual measures.
  • PQRSPRO offers guidance to determine the best approach for your reporting, along with real time data calculation, PQRS validation, and performance feedback.

Please note: ML Medical Billing does not receive any incentive from PQRS PRO or accept any responsibility for services provided by PQRS PRO. This message is only intended to update our clients about important PQRS changes in 2015 and avoid the -2% Payment Adjustment in 2017 for non-reporting.

Additional Resources

Specialty recommendations can be found here for 2015. 

Sign up for a free Webinar or view pre-recorded webinars in PQRS PRO’s Video Library.

Source: https://www.pqrspro.com/