PQRS Update

PQRS Update:

In 2015, eligible providers who bill under the physician fee schedule must report successfully under PQRS to avoid a -2.0% reduction in their 2017 fee scheduled.

Requires reporting of 9 measures (or if less available 1-8) on 50% of eligible patients within a 12 month reporting period (January 1-December 31, 2015) in order to avoid the -2.0% penalty. (requires reporting of at least 1 cross “cutting measure” which is a new category of measure for 2015)

PQRS categories:

Measure Care Coordination Population Health Safety Effective Care Cross Cutting
#128: BMI Screening X X
#130: Medication Documentation X X
#131:   Pain Assessment X X
#134: Clinical Depression Screen X
#154: Falls Screen X
#155: Falls Care Plan X
#181:   Elder Maltreatment Screen X
#182: Functional Outcome Assessment X X

 

The following measures are claims based reporting measures applicable to PT, OT and ST:

Physical Therapy

Measure Name CPT Encounter for Reporting
#128: Body Mass Index Screening and Follow-Up 97001 (report 1x per pt. per year)
#130: Documentation of Current Medications
in the Medical Record
97001, 97002 (report each visit)
#131: Pain Assessment and Follow-up 97001, 97002 (report each visit)
#154:   Fall Risk Assessment#155:   Falls Plan of Care 97001, 97002(report 1x per pt. per year)
#182: Functional Outcome Assessment 97001, 97002 (report each visit)

 

Occupational Therapy

Measure Name CPT Encounter for Reporting
#128: Body Mass Index Screening and Follow-Up 97003 (report 1x per pt. per year)
#130: Documentation of Current Medications in the Medical Record 97003, 97004, 97532
(report each visit)
#131: Pain Assessment and Follow-up 97003, 97004, 97532
(report each visit)
#134: Screening for Clinical Depression and
Follow-up Plan
97003 (report 1x per pt. per year)
#154: Falls Risk Assessment & #155:   Falls Plan of Care 97003, 97004
(report 1x per pt. per year)
#181:   Elder maltreatment and Follow-up Plan 97003 (report 1x per pt. per year)
#182: Functional Outcome Assessment 97003, 97004 (report each visit)

 

Speech Therapy

Measure Name CPT Encounter for Reporting
#130: Documentation of Current Medications in the Medical Record 92507, 92508, 92526, 97532
(report each visit)
#131: Pain Assessment and Follow-up 92507, 92508, 92526, 97532
(report each visit)