Understanding PQRS

In order to keep from being penalized next year we will need to learn about the new PQRS or Physician’s Quality Reporting System. It is required by Medicare to report patient’s condition and treatment. The program is supposed to be an incentive by allowing for a small payment for participation but in 2015, next year, physicians will be penalized for not registering and participating in the program. This is quite complicated and covers many specialties as well as PCPs. It will amount to a secondary CPT code added to the claim. We will be offering more information on PQRS next month.

It is used to report not only the present condition of the patient to Medicare but the ongoing goals and how the patient is proceeding through the course of treatment.  This is only for Part B (professional services, Railroad Retirement and Medicare Secondary Payor by eligible providers. These eligible providers are:

Doctor of Medicine
Doctor of Osteopathy
Doctor of Podiatric Medicine
Doctor of Optometry
Doctor of Oral Surgery
Doctor of Dental Medicine
Doctor of Chiropractic

Physician Assistant
Nurse Practitioner
Clinical Nurse Specialist
Certified Registered Nurse Anesthetist (and Anesthesiologist Assistant)
Certified Nurse Midwife
Clinical Social Worker
Clinical Psychologist
Registered Dietician
Nutrition Professional

Physical Therapist
Occupational Therapist
Qualified Speech-Language Therapist


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