![]() Penalty for not reporting 2015 PQRS is 4% for groups (with 2-9 providers) and solo providers. Things to Know:Ĭlaims processed by MAC (appeals, re-openings and claims adjustments) will have to reach the Medicare claims system data warehouse by 16th February 2016 in order to be included in the analysis Since CMS tracks the use of PQRS codes thoroughly, it becomes necessary to have trained coders and billers on board. ![]() These codes are referred to as CPT II codes by Medicare, and addition of the CPT II codes triggers participation for the practice in PQRS. Additional documentation elements included in a physician’s report can help coders attach the right PQRS CPT codes. If practices are using claims-based reporting method for submitting PQRS data to the CMS, their coders will have to use the right codes. ![]() If eligible professionals don’t participate in the 2015 PQRS program successfully, they will have to face a 2% reduction in Medicare payments in 2017. Will your Practice avoid Billing Pitfalls when Participating in PQRS?Īre your billers trained to bill appropriately while participating in PQRS? Prior to participation, ensuring the preparedness of your billing department is as important as reviewing the current year’s measure specifications.
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