PQRS

General Introduction

To improve quality of the healthcare in the US, Medicare has a innovative program called Physician Quality Reporting System (PQRS) that rewards physicians for reporting quality measures like checking cholesterol levels on diabetics patients, doing mammograms, giving smoke cessation advice, etc.

With the PQRS incentive program, medical providers can earn an incentive payment of 1% above the regular Medicare Physician Fee charges. In 2010, $234 million was paid to health professionals participating in the PQRI program. The average bonus payments were $1,956 per eligible professional and $18,525 per practice.

Using MDinteractive to report PQRS data

It is very easy to report PQRS measure groups using MDinteractive:

1- Register with MDinteractive for free. You only need to create one PQRS account per medical group

2- Each provider needs to sign a consent form. Sign consent to submit data to Medicare online or fax this PQRS Consent Form to MDinteractive at 866-251-4069

3- Choose one PQRS Measure Group you wish to report for 30 patients you saw in 2011 (all patients must be Medicare Fee For Service) or choose 3 individual PQRS measures and report at least 80% of the patients to whom the individual measures apply.

The following measure group options are available with MDinteractive:

4- Answer questions regarding the patients you are reporting (date of HgA1c for example).

5- Pay submission fee to MDinteractive using your credit card. MDinteractive will then submit your data to Medicare ($199 per provider)

5- Receive PQRS bonus during the Fall of 2012

Eligible Professionals

Under PQRS, covered professional services are those paid under or based on the Medicare Fee Schedule (PFS). To the extent that eligible professionals are providing services which get paid under or based on the PFS, those services are eligible for PQRI.

The following professionals are eligible to participate in PQRS:

1. Medicare physicians

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

2. Practitioners

  • 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
  • Audiologists (as of 1/1/2009)

3. Therapists

  • Physical Therapist
  • Occupational Therapist
  • Qualified Speech-Language Therapist