Today’s blog post comes from WebPT Co-Founder Heidi Jannenga, PT, MPT, ATC/L.
Can you believe it’s already November? That means two things: Thanksgiving and PQRS 2013 (if you treat Medicare patients, of course). I know we’d much rather fill our thoughts—and bellies—with turkey, dressing, and buttery mashed potatoes. But you have to make room somewhere for Physicians Quality Reporting System (PQRS, formerly known as PQRI). You can’t smother it with gravy or tuck it behind excess cans of cranberry jelly because while PQRS might induce thoughts of dread, it is absolutely necessary—and contrary to popular belief, not all that challenging or stressful.
Let’s start off with the basics. 2013 is the first year that PQRS is “mandatory.” I mean you could skip it, blow it off completely, or pretend you didn’t know, but before you do that, you should know that CMS will penalize you in the form of a 1.5% adjustment on your fee schedule in 2015. I don’t know about you, but my clinic couldn’t afford that. Now if you say that Uncle Sam, or the government, might dilly dally on all this, let me say that insurance regulations are tightening and pay for performance methodologies are quickly becoming the name of the game. It’s inevitable. So why fall behind? Get with the program and meet PQRS head on. Plus, this year, compliance will earn you a 0.5% incentive payment on your total allowed charges during the reporting period.
Now, some of you may be thinking: “Meet it head on?! But it’s too hard!” Or, “I don’t have the time.” But the truth is: it’s just not that bad! As a matter of fact, you are probably already performing many of the tests and measures needed to meet many of the PQRS requirements.
So let’s talk details. CMS actually only requires you to select and complete three measures for every qualified Medicare patient you treat during 2013. Measure #182, Functional Outcome measure, for example is one you should already be completing to meet Medicare requirements even without participating in PQRS.
For your second and third measures, take a look at your practice. Do you see diabetic patients? There are diabetic outcome measures you can choose. A few other gimmes: BMI, Pain Assessment, and Fall Risk Assessment. You’re probably already assessing these items with your patients anyway.
A common misconception is that you need to perform these tests multiple times during the episode of care. But the truth is that you only need to report most of these measures in association with CPT™ 97001 or 97002 once a year. That means you only report them on your initial examinations, and you are done.
Your mind a little eased yet? Well, let’s ease it fully. We here at WebPT make PQRS easy, and I’m proud to say that we’re one of only two certified PQRS registries in the industry—as approved by CMS. We give you not one, but two reporting method routes. Choose claims-based, and you’ll be able to use your WebPT documentation to help you submit the appropriate G codes to Medicare along with billing. Or, go with registry-based and we’ll automatically aggregate your PQRS data from your documentation and send it to CMS at the end of the year—no muss, no fuss for you.
I personally recommend registry-based, because as a PT, I understand how busy the day-to-day can truly get. Registry-based reporting takes a lot off your plate. Sure, it might cost a little more upfront, but the investment is definitely worth it. No matter which reporting method you choose, WebPT will automatically qualify each of your Medicare patients based on the requirements for each of the measures you choose. If a patient qualifies based on age, diagnosis code, etc., the PQRS-related questions appear during the appropriate examination. We also provide a compliance report to help you ensure you’re meeting requirements and therefore avoiding any penalties.
Let’s face it: every penny helps, especially now, and I wouldn’t want to take even the slightest chance of leaving 1.5% on the table.
All this PQRS chatter—or perhaps the initial turkey talk—has made me mighty hungry! I’m sure you’ve got holiday festivities—or leftover Halloween candy—on your mind as well. Let’s all clear PQRS off our plates, so we can fill them with happier and more filling things. Like I said above, PQRS is necessary. You can’t procrastinate anymore; it’s time to hop to it and protect your practice from penalties and fines.