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Therapy PQRS Panic

March 6, 2014 1 Comment

Stress. Woman stressedIt seems like therapy PQRS panic is setting in, and setting in fast.  I am hearing from practices from Minnesota to California to Florida and parts in between.  Most folks that are in contact with me have heard me speak at a webinar or perhaps have read my blog posts on PQRS over the past month or two.  Many listened to the live broadcast webinar that I did with Clinicient (still available as a recording and you can download the handouts).  Much of the confusion surrounds the misinformation that is swirling around, including web resources that are not up date on the 2014 PQRS Program.

If you are a private practice, and you would like to stave off the 2% Medicare payment cuts in 2016, you may want to consider PQRS at the minimum level to save your practice some cash in 2016.  The least expensive way to do this (FREE) is via claims-based reporting.  If you still are on paper and pencil documentation (even if you are using WORD templates), or is you have a therapy EMR that makes it easy for you to document the PQRS Measures in the record, and identify the codes for the claim.  If your therapy EMR is also your billing platform, it is likely that the process is automated (check with your EMR vendor).

Therapy PQRS Panic – Sorting It Out

So how to go about sorting out therapy PQRS Panic?  Here are some suggestions and resources to assist you.

  • Before implementing your PQRS reporting, ensure that you understand all the measures that are available for reporting – in two previous posts I focused on PT PQRS Measures and OT PQRS Measures
  • Make sure you are reporting correctly on the measures, and on the required CPTS codes.  I have discussed measure changes for medical management in this post.
  • Download the 2014 PQRS information from CMS, while somewhat overwhelming, the 2014 PQRS Measure Guide (print the pages for the therapy measures), is essential in understanding how to report and what documentation and coding is required
  • APTA members should avail themselves PQRS resources at their website.  They have continued to add to their repository of PQRS information.
  • The OT and PT PQRS Measures are not all the same.  If you have both PT and OT in your clinic, it is essential to know the difference.
  • The minimum measure to report are 3, I will repeat that again: the minimum number of measure to report are 3, not 6, not 8 and not 9.
  • The requirement for a bonus of 0.5% is 9 measures, but of the nine required many measures may not be applicable, so you would only report on the applicable measures.  In fact, there are only 6 general measures for PT, and an additional 2 for wound care, while there are 9 measures for OT.

Have you decided to begin reporting PQRS via claims reporting to stave off the 2% penalty in 2016?  Do you know if you have setup your reporting system properly?  Do you know how to assess if your reporting is accurate and being accepted?

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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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  1. Great summary, Nancy. As usual, hit the nail on the head. REALLY important not to over complicate this.


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