Last week, we covered the registry-and claims-based reporting methods for PQRS. In this post, I’ll discuss the complexities associated with reporting PQRS using the Group Practice Reporting Option (GPRO). In past years, GPRO seemed to be the most practical option for practices with more than two eligible professionals. This year, however, Medicare added more stipulations to the GPRO program—and in some cases, those add-ons might make the whole thing more trouble than it’s worth.

Medicare Open Forum - Regular BannerMedicare Open Forum - Small Banner

The Basics of GPRO

  • GPRO is available to clinics with two or more eligible professionals all of whom operate under the same tax ID, or TIN.
  • To report using GPRO, your clinic must self-nominate through CMS. In 2014, nomination was not open until April, and this year’s nomination will probably open around the same time. For those who would prefer to get a jump-start on fulfilling their reporting requirements, that delay could be pretty frustrating.
  • The main difference between GPRO and individual reporting is that the eligible professionals in the participating practice are able to meet the requirements for satisfactory reporting together—meaning each individual therapist does not necessarily have to report on 50% of his or her patients. For example, in a practice with two eligible therapist, the first therapist could report on 40% of his or her patients, and the second therapist could report on 60% of his or her patients.  

Three Ways to Report

  1. The first reporting method available to 2015 GPRO participants is essentially the same as the individual submissions process. That is, the participating practice must report nine measures for at least 50% of their Medicare Part B FFS (fee-for-service) patients. These measures must cover at least three NQS domains, and at least one measure must qualify as a cross-cutting measure.
  2. With the second option, practices must report six measures across two NQS domains for at least 50% of its Medicare Part B FFS patients, and it must conduct Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey using a CMS-certified survey vendor. The certified vendor will administer a patient satisfaction survey on the participating practice’s behalf and aggregate the data. Please note that the practices are responsible for the cost associated with conducting these surveys. For more information on the CAHPS survey, click here.
  3. Finally, some practices have the option of using CMS’s GPRO Web Interface. The specifics on this option are still a bit fuzzy, but here’s what we know:
    1. With this option, groups must report on all measures included in the interface for their first 248 Medicare Part B patients. If they have fewer than 248 Medicare patients, then they must report on at least one measure for 100% of their Medicare Part B patients.
    2. Only practices with 25 or more eligible professionals can report via the GPRO Web Interface.
    3. As of now, practices that use the interface are not subject to the MAV process. However, this could change.
    4. Using the interface could prove arduous as it requires double-data entry (i.e., you must manually enter all of your patient information).

If you have 100 or more eligible professionals participating in GPRO—regardless of which GPRO reporting method you choose—you must also add the CAHPS survey component.

Now What?

Although your clinic’s optimal GPRO method will depend on your specialties, number of eligible professionals, payer mix, and applicable measures, generally speaking, GPRO option number one appears to be the simplest. It’s also the one supported by WebPT’s registry-based PQRS service.

If you choose GPRO option number two, it’ll cost you—literally, you’ll have to pay a third-party organization to administer the CAHPS survey. And on top of the financial burden of the survey, it’s on you to actually find a CMS-certified vendor to conduct it. So, if you’re a practice with more than 100 eligible professionals—meaning you’re required to conduct a CAHPS survey if you wish to report as a group—then you might want to consider the pros and cons, including the financial burden, of GPRO versus individual submission.

The Web Interface method also has some drawbacks. First of all, it’s only open to clinics with at least 25 eligible professionals. On top of that, the rules regarding the number of measures you’re required to report are murky at best. And worst of all, it requires double data-entry—meaning you have to input patient information into your registry, and then again into the Web Interface.


Is your practice considering participating in PQRS using GPRO? What questions or concerns do you have? Leave ’em in the comments section below.

  • articleDec 26, 2013 | 5 min. read

    Most Frequently Asked Questions from our PQRS Webinar

    Once I pick my measures within WebPT, am I stuck with those throughout the year or can I change them? Yes, whichever measures you select will be your measures for the remainder of the year. You have until March 31, 2014, to make your final selection.   Is the requirement for successful reporting with the back pain measures group 20 patients per therapist or 20 patients per practice? It’s 20 patients per therapist. It doesn’t matter if …

  • articleNov 5, 2013 | 3 min. read

    Founder Letter: PQRS 2014

    Well, it’s November already, and that means two things: Thanksgiving and Physician Quality Reporting System (PQRS). Sure, PQRS doesn’t involve mouthwatering roasted turkey, savory stuffing, or creamy mashed potatoes, but it has become quite the November tradition for us here at WebPT. You see, this is the time of year that the Centers for Medicare & Medicaid Services (CMS) typically confirms the details of next year’s reporting requirements, thus allowing us to update our PQRS solution (claims- …

  • webinarDec 20, 2013

    Preparing for PQRS 2014

    In December, we hosted a webinar focused on the new PQRS regulations. This session broke down all the rules for 2014 to ensure you’ll be prepared to play by them and therefore not incur any penalties. During this presentation, we: Detailed the PQRS requirements for 2014 Described the different reporting methods Explained how you can ensure you successfully report

  • Here's What PTs, OTs, and SLPs Need to Know About PQRS 2015 Image

    articleNov 13, 2014 | 8 min. read

    Here's What PTs, OTs, and SLPs Need to Know About PQRS 2015

    In the spirit of the season, today we give thanks for Medicare’s brand new Final Rule . Drier than overcooked turkey, we decided to carve up this bird into the most pertinent chunks of Physician Quality Reporting System (PQRS) information for you and your practice so you don’t have to. Here’s what you need to know about PQRS 2015: Measures, Measures, Measures Medicare likes measures––225 of them to be exact––and they don’t care who knows. Thankfully, all …

  • articleNov 4, 2013 | 3 min. read

    What PQRS Could Look Like in 2014

    On July 19, 2013, the Centers for Medicare & Medicaid Services (CMS) published the 2014 Medicare Physician Fee Schedule (MPFS) Notice of Proposed Rulemaking (NPRM) in the Federal Register. According to this summary , most of the policies were open for comment until September 6, 2013 and, pending final decisions (which hopefully will occur this month), will take effect on January 1, 2014. The 605-page document contains proposals for policy changes on everything from reimbursements to the …

  • Founder Letter: Dodging Data will be Your Demise (or, Why You Should Complete PQRS)  Image

    articleNov 5, 2015 | 6 min. read

    Founder Letter: Dodging Data will be Your Demise (or, Why You Should Complete PQRS)

    By and large, Medicare’s 2016 Final Rule was underwhelming—and for most of us (including me), that probably warranted a big sigh of relief. But while there are no major changes on deck for this year, one thing that definitely should have caught your eye if you perused our Quick Guide to the 2016 Final Rule was the verbiage alluding to the future of PQRS—specifically, the possibility that PQRS reporting as we know it could cease to exist …

  • The Scoop on PQRS Image

    articleNov 18, 2013 | 5 min. read

    The Scoop on PQRS

    What is PQRS? The Centers for Medicare and Medicaid Services (CMS) developed Physician Quality Reporting System (PQRS), which mandates that eligible professionals meet standards for satisfactory reporting. If you are not PQRS-compliant in 2014, CMS will assess penalties. However, we do not yet know what the penalty amount is or how CMS will assess it. There also is a chance that CMS will provide incentive payments for successfully completing PQRS, as they did in 2013. Again, we …

  • Final Rule 2015: Here’s What You Need to Know Image

    articleNov 6, 2014 | 3 min. read

    Final Rule 2015: Here’s What You Need to Know

    The summary of this year’s Final Rule is hot off the presses, which means that—among other things—we now know the details regarding PQRS 2015. For those who have been following the PQRS saga since the program first came into being in 2007, it should come as no surprise that Medicare has yet again upped the ante for compliance. Based on the fact sheet CMS provided , here’s the scoop on this year’s reporting requirements: Eligible professionals who …

  • Think You Know PQRS? [Quiz] Image

    articleDec 2, 2015 | 1 min. read

    Think You Know PQRS? [Quiz]

    PQRS 2016 is on the horizon, and whether you’re an old pro or a reporting rookie, the details of this Medicare quality data program can be tough to keep straight. And with a potential 2% negative payment adjustment on the line, it’s imperative that you understand every facet of this quality data reporting program from A to Z—er, P to S. Think you’ve got PQRS down pat? Prove your smarts with our ten-question quiz. Need a bit …

Achieve greatness in practice with the ultimate EMR for PTs, OTs, and SLPs.