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Additional PQRS Topics:
|Our practice submitted what was ostensibly successful meaningful use data in January 2013 for the first time (our first reporting period began October 2012 and our first reporting was January 2013). We submitted at the end of January 2013 so we are still waiting for payment.
Should we still be participating in PQRS via claims if we continue to participate in meaningful use?
I assume that if we are using an e-RX system meaningfully within our EMR, we can stop reporting e-Rx via PQRS and Medicare claims.
|Because you achieved meaningful use in 2012, you are exempt from the 2014 e-prescribing penalty and do not need to report e-Rx.
However, you should still be participating in PQRS. There is a 0.5% bonus for participating in 2013, and you must participate in 2013 to avoid the 1.5% penalty in 2015. You can continue to report by claims if this has worked for you in the past. It is also possible to submit your PQRS data through your EHR, if you are using one on the approved list for PQRS.
More information about EHR reporting can be found on the Academy website.
|We would like to report measures through an approved EHR. What would be the specifications or qualifications to do this?||
To report through an electronic health record, you must verify that your EHR vendor has been approved for PQRS. Check the list.
There are five measures that ophthalmologists can report through the EHR. They are:
NOTE: Your vendor is responsible for ensuring compliance with the measure specifications, not you.
In 2012 we attested to Meaningful Use for our doctors and were successful on the 90 day period. We also had previously received PQRS payments. In 2013 we will again attest to Meaningful Use through our EHR software.
With the statement "Participating means attempting to report at least one PQRS measure between Jan. 1 and Dec. 31, 2013." Doesn't the Meaningful Use also show that we are submitting PQRS measures? After listening to the Webinar on this subject and reading the Physician Quality Reporting System (PQRS) information on the website, I am still confused by what this really means.
|Though the meaningful use measures are similar to the PQRS measures, you still need to report separately for both programs in 2013. If your EHR is approved for PQRS reporting (check the list), then you are able to submit your PQRS data from your EHR instead of reporting by claims if you choose. This will allow you to receive the PQRS bonus.
You may also choose to continue to report three measures by claims to get the PQRS bonus. If you are only interested in avoiding the PQRS penalty, then yes. You can report one measure one time over the course of the year by claims.
|Do we have to “register” with CMS before reporting measures from our office?||No. Just begin reporting the measures.|
|Do we report PQRS on every Medicare Part B, Medicare as a secondary payer and Railroad Medicare patient we see?||Look at the diagnosis codes for the three measures selected. When any of those diagnosis codes are reported on the same day as an exam, the PQRS measure code should be reported too.|
|Is it true that for 2013, CMS will only require physicians to attempt to report PQRS in order to avoid the 2015 penalty?||Yes. Making an attempt to report will exempt practices from the penalty. To receive the incentive payment, physicians must correctly report 50 percent of the time if reporting by claims, and 80 percent of the time if reporting via registry or EHR.|
|Will CMS verify our reporting data to assure us we are reporting correctly?||CMS does not have a mechanism to do this. As a result, Academy/AAOE recommend internal verification by looking at remittance advices and making sure that when PQRS is reported either N365 This procedure code is not payable, it is for reporting/information purposes only or CO96 Noncovered charge(s) is listed on the remittance advice.|
|Can I receive both the meaningful use incentive and the PQRS incentive? What about the e-prescribing incentive?||Physicians are eligible to receive both the meaningful use incentive payment and the PQRS incentive payment for the same year. Physicians who participate in the Medicare EHR incentive program are not eligible to receive the e-prescribing incentive payment in the same year, but these physicians should continue reporting e-prescribing to avoid the e-prescribing penalty.|