Meeting and following Medicare Regulations are important for appropriate physical therapy practice management and necessary to provide the best patient care. However, this program can seem confusing at times and tends to generate questions from physical therapists concerning definitions and purpose. Here are four of the most common PT PQRI questions and answers.
What is the difference between PQRI and PQRS?
The Physician Quality Reporting Initiative (PQRI) is a temporary initiative that was established by the Center for Medicare and Medicaid Services (CMS). As of January 2011, this program is permanent. With this change, the name changed from the PT PQRI to Physician Quality Reporting System (PQRS). Keep in mind, this change is relatively new and both terms virtually stand for the same system.
What is the function of PQRS?
PQRS provides a standard for 'satisfactory reporting' for Medicare Claims in an effort to optimize payment efficiency. By establishing a standard, the amount of fraud could also be reduced. CMS understands the additional physical therapy practice management efforts that this program entails, and in return offers a 1% bonus on charges.
How do I become eligible for the bonus?
To become eligible for the 1% bonus for Medicare Part B Physician Fee Schedule, you have to meet required measures for a specific percentage of your Medicare patients. There are many measures to choose from, including the use of an EMR. For claims-based patients, 50 percent need to be documented using these standards for reporting and for registry-based patients the percentage of those documents must be at least 80 percent.
What is claims-based reporting and what is registry-based?
Claims-based reporting measures clinical practice reported on claims. Here, the physical therapy professional or group practice themselves are responsible for the submission to CMS. Typically utilized more in smaller sized practices, claims-based reporting is cheaper and allows the professional to be in full control of data completion. Keep in mind that with this option, you'll need to have someone in the office with excellent knowledge of PQRS and can complete audits.
Registry-based reporting allows the professionals or clinic to submit data electronically to a registry. Here the data can be stored. The registry is then responsible for the submission of the measures to CMS on behalf of the clinic. With registry-based reporting, staff productivity is maintained and professionals can enjoy added insight and assistance when deciding on what is most appropriate. It is important to remember that with registry-based reporting, there is a fee, although money will be saved when office supplies and staff time are considered.
To run a more efficient and accurate PT clinic, consider the implementation of PQRS and take the time to fully understand the process, potential savings and benefits such as fraud reduction and payment optimization.
About this Author
Tom Brauch is the Director of Marketing at WebPT, the leading web-based Electronic Medical Record (EMR) system for physical therapy clinics. WebPT offers a complete suite of tools to streamline patient documentation and clinic operations. Our PQRS reporting system is approved by the Center for Medicare and Medicaid Services (CMS) as a certified registry for PT PQRI. Find out how WebPT and PQRS can help improve you physical therapy practice management.
What is the difference between PQRI and PQRS?
The Physician Quality Reporting Initiative (PQRI) is a temporary initiative that was established by the Center for Medicare and Medicaid Services (CMS). As of January 2011, this program is permanent. With this change, the name changed from the PT PQRI to Physician Quality Reporting System (PQRS). Keep in mind, this change is relatively new and both terms virtually stand for the same system.
What is the function of PQRS?
PQRS provides a standard for 'satisfactory reporting' for Medicare Claims in an effort to optimize payment efficiency. By establishing a standard, the amount of fraud could also be reduced. CMS understands the additional physical therapy practice management efforts that this program entails, and in return offers a 1% bonus on charges.
How do I become eligible for the bonus?
To become eligible for the 1% bonus for Medicare Part B Physician Fee Schedule, you have to meet required measures for a specific percentage of your Medicare patients. There are many measures to choose from, including the use of an EMR. For claims-based patients, 50 percent need to be documented using these standards for reporting and for registry-based patients the percentage of those documents must be at least 80 percent.
What is claims-based reporting and what is registry-based?
Claims-based reporting measures clinical practice reported on claims. Here, the physical therapy professional or group practice themselves are responsible for the submission to CMS. Typically utilized more in smaller sized practices, claims-based reporting is cheaper and allows the professional to be in full control of data completion. Keep in mind that with this option, you'll need to have someone in the office with excellent knowledge of PQRS and can complete audits.
Registry-based reporting allows the professionals or clinic to submit data electronically to a registry. Here the data can be stored. The registry is then responsible for the submission of the measures to CMS on behalf of the clinic. With registry-based reporting, staff productivity is maintained and professionals can enjoy added insight and assistance when deciding on what is most appropriate. It is important to remember that with registry-based reporting, there is a fee, although money will be saved when office supplies and staff time are considered.
To run a more efficient and accurate PT clinic, consider the implementation of PQRS and take the time to fully understand the process, potential savings and benefits such as fraud reduction and payment optimization.
About this Author
Tom Brauch is the Director of Marketing at WebPT, the leading web-based Electronic Medical Record (EMR) system for physical therapy clinics. WebPT offers a complete suite of tools to streamline patient documentation and clinic operations. Our PQRS reporting system is approved by the Center for Medicare and Medicaid Services (CMS) as a certified registry for PT PQRI. Find out how WebPT and PQRS can help improve you physical therapy practice management.
