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Occupational Therapy PQRS

February 28, 2014 2 Comments

There are 9 occupational therapy PQRS measures in 2014 for claims-based reporting (free).  Stamp qualityMany are the same measure for physical therapy reporting, however there are some different options for occupational therapy.  Before we get to the measures, it’s important to clear up some misunderstanding about the minimum number of measure that must be successfully reported (via claims based reporting).  For all eligible providers (EP) reporting requirements are for 9 measures to obtain the 0.5% bonus payment for 2014, and a minimum of 3 measures (as applicable) in order to stave off the 2.0% payment penalty in 2016.  However if not all available measure are applicable, the claims will go through the Measure Applicability Validation Process (MAV) which will allow QualityNet to determine whether you should have reported quality data codes for additional measures and/or covering additional NQS domains.  The minimum reporting requirements to avoid the penalty apply to physicians, and other providers including physical and occupational therapists.

Occupational Therapy PQRS – Some Measures Shared with Physical Therapy

Let’s cut to the quick and see the table of the occupational therapy PQRS measures.  Some of these measure are also applicable to physical therapy, and are so noted by the applicable physical therapy evaluation codes.

Occupational Therapy PQRS Measures 2014

Measure #Measure DescriptionCPT CODES
#128Preventative Care & Screening: Body
Mass Index (BMI) Screening & Follow-Up
97001, 97003, 97803
#130Documentation of Current Medications
in the Medical Record
97001, 97002, 97003, 97004, 97110
97140, 97532, 97802, 97803, 97804
#131Pain Assessment & Follow-Up97001, 97002, 97003, 97004,
#134Screening for Clinical Depression &
Follow-Up Plan
#154Falls: Risk Assessment
97001, 97002, 97003, 97004
#155Falls: Plan of Care
97001, 97002, 97003, 97004
(Only when 1100F is reported for Measure #154)

#181Elder Maltreatment Screen &
Follow-Up Plan
97003, 97802, 97803
#182Functional Outcome Assessment
97003, 97802, 97803
#226Tobacco Use: Screening and
Cessation Intervention
97003, 97004

Are you an occupational therapist?  Are you currently reporting on PQRS measures?  Are you reporting on the minimum number of measure to stave off the 016 2.0% penalty?  Are you reporting on all the applicable procedure codes to ensure your efforts pay off?

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Nancy Beckley

Nancy J. Beckley MS, MBA, CHC: President-Nancy Beckley & Associates LLC. Compliance outsourcing, risk assessment, compliance plans, compliance training, auditing, due diligence, investigation support for therapy providers.

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Comments (2)

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  1. Janice Jean says:

    I am just staring to do PQRS for occupational therapy do you a list that is more current than this one for 2014? Thanks

  2. Hi Janice. Thank you for your comment. We did do a 2015 update for PQRS for physical therapy: Stay tuned for 2016 PQRS updates for claims based reporting for physical therapy and occupational therapy.

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