There are 6 PQRS measures for physical therapy that outpatient practices should consider for PQRS reporting in 2014. Sit back and relax, have a cup of tea: it won’t be as complicated as it seems. But first let’s take a step back and explain a few details related to claims based reporting, an easy way to get started with the program:
- PQRS reporting is only for those physical therapists billing on the CMS 1500 form (rehab agencies, CORFs, SNF and hospital outpatient therapy providers are not eligible).
- Individual providers (in the group practice) must report on at least 3 measure on 50% of eligible patients to be exempted from the 0.2% penalty (applied in 2016)
- Individual providers must report on 9 measure (or 1-8 as applicable) on 50% of eligible patient in order to qualify for the 2014 0.5% bonus payment (paid in 2015)
Note there is also the option for reporting PQRS codes for physical therapy via a group registry including an EMR based registry. Stay tuned for a future post on PQRS reporting via registry.
6 PQRS Measures for Physical Therapy – Choose 3 to Avoid Penalty in 2016
The PQRS measures finalized for physical therapy in 2014 are:
|Measure #||Measure Description|
|128||Preventive Care and Screening: BMI Screening and Follow-up|
|130||Documentation and Verification of Current Medications in the Medical Record|
|131||Pain Assessment Prior to Initiation of Patient Treatment|
|154||Falls: Risk Assessment|
|155||Falls: Plan of Care|
|182||Functional Outcome Assessment|
Breathe a sigh of relief, if you have never participated in the PQRS program, participation this year via your submitted claims should be strongly considered (particularly if have a high percentage of Medicare patients). Claims based reporting on at least 3 measures will stave off the 0.2% reduction in payment in 2016. The American Medical Association has published great “Measure” guidelines in past years, and this year they are still in the process of updating their website with current measures. Keep a look out on the AMA site for the measures noted in the table above, or if you have time on your hands you can confuse yourself by reading through everything on the CMS PQRS site.
What measures do you plan to use?