FPM Home. Past Issues. CME Quiz. Getting Paid. Quick Tips. Peer Reviewers. Supplement Sponsors. The most common method the Nuclear Medicine community has for reporting measures is individual measures reporting. The three mechanisms that can be used to report these measures are described below:.
EHR-based reporting : Report at least 3 measures. When this occurs, the only CMS-approved mechanism for reporting is claims-based reporting. Claims-based reporting must be completed using a 50 percent sample of applicable Medicare Part B fee for service patients.
If you are eligible to participate in PQRS, you should — otherwise you will be fined and see a reduction in your Medicare Part B payments. As you see by now, PQRS codes can get complicated pretty quickly.
Try TheraNest free for 21 days— no credit card required. Click here to start your free trial. What is PQRS? Be prepared for plenty of abbreviations. Beginning in , the PQRS program has moved into a penalty-only phase. The penalty will continue at 2 percent in future years. In addition to the PQRS penalty for nonparticipation, EPs and group practices will be subject to an additional 2 percent or 4 percent penalty, depending on their group size, due to the value-based payment modifier VM.
The VM provides for differential payment to a physician or group of physicians under the Medicare physician fee schedule based on the quality of care furnished compared with cost during a performance period.
There are several ways that surgeons can participate in the PQRS program. EPs can participate individually in the PQRS program through one of four methods: claims-based reporting, traditional registry-based reporting, qualified clinical data registry QCDR -based reporting, or electronic health records EHR -based reporting. A detailed description of each option is provided in the next section. Surgeons who are part of a group should note that group practices also may collectively report PQRS data by selecting a reporting method from the group practice reporting option GPRO listed in the document available on the CMS website.
Surgeons who are part of a group practice but would like to report individually should call the CMS QualityNet Help Desk at to ensure that their institution has not already enrolled them for the GPRO. Note that this column focuses on the individual EP reporting options. Of these nine measures, one must be from a list of what CMS defines as cross-cutting measures. These are broadly applicable measures that apply to many specialties.
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