What is PQRS?
Created by Center for Medicare and Medicaid Services (CMS), Physician Quality Reporting System (PQRS) mandates that physical therapists, occupational therapists, and qualified speech-language therapists meet the standards for satisfactory reporting. If you are not PQRS compliant in 2013, CMS will assess penalties of 1.5% of your Medicare payments as fines in 2015. However, if you are compliant, you will earn a 0.5% incentive payment on your total allowed charges during the reporting period.
While it seems like a pain, PQRS is absolutely necessary. Save yourself the headaches—and fines—and let WebPT manage PQRS for you. We’re a Certified PQRS Registry, so with us, staying compliant is easy. Here are the benefits:
- Avoid a 1.5% reimbursement penalty in 2015
- Earn a 0.5% incentive payment
- Let WebPT manage PQRS for you with our registry-based reporting method
- Improve measure reporting efficiency through our EMR
- Ensure compliance
- Elevate your clinic’s standard of care while saving yourself time, money, and stress
What are the reporting methods?
There are two different methods for reporting PQRS:
- Registry-Based (Automatic Individual Submission)
This option manages most of PQRS for you. Because we merge PQRS with standard documentation, you simply report your PQRS measures directly within the patient record. We then aggregate that data, compile it into a digital form, and submit it to CMS. So, after setup, you document, and we take care of the rest—no muss, no fuss. Essentially, registry-based reporting means you’ll never forget PQRS because we remember for you.
- Claims-Based (Manual Individual Submission)
Claims-based reporting allows you to use your WebPT documentation to help you submit the appropriate CPT codes to CMS along with billing. As a note, in order to successfully complete claims-based PQRS reporting, you must report at least 50% of patients.
Some food for thought on claims-based reporting: being in control of your own data may prove to be a double-edged sword. You must be your own auditor. Of course, if you’re a smaller practice and Medicare patients make up a small portion of your payer mix, then this option may be worth considering. Otherwise, claims-based reporting will require more work, time, and responsibility for you and your clinic. It’ll be up to you to ensure you stay compliant.
While we recommend registry-based, no matter which reporting method you choose, you’re better protecting your practice from penalties.
How do I stay compliant?
To ensure compliance, therapists should complete a PQRS form with at least three applicable outcome measures for every Medicare patient. Here are some of WebPT’s available measures:
- BMI Screening and Follow-up (Measure #128)
- Diabetic Foot & Ankle Care; Neurological Evaluation (Measure #126)
- Diabetic Foot & Ankle Care; Ulcer Prevention/Footwear Evaluation (Measure #127)
- Pain Assessment Prior to Initiation of Therapy (Measure #131)
- Documentation and Verification of Medications (Measure #130)
- Falls Risk Assessment (Measure #154)
- Falls Risk Assessment & Plan of Care (Measure #155)
And that’s PQRS in nutshell. All in all, it’s not too tough to crack. Still, we understand that it can be a lot to digest. That’s why we’re here for you. Check out our PQRS webinar to get further acclimated. And if you’re a WebPT Member, put us to work for you now. We’ll help you ensure accuracy, efficiency, and protection from penalties, plus you’ll save yourself a lot of time. And everyone could use more of that.
(Not a Member, but want our help with PQRS? Schedule a demo today to see how our documentation solution paired with PQRS can help you achieve greatness in therapy practice.)