Medicare will pay physicians a lump sum bonus equal to 0.5% of their 2014 Medicare reimbursement in exchange for successfully reporting data under the Physician Quality Reporting System (PQRS).   The PQRS program has been in place since 2007, but reporting for 2014 is the final opportunity to earn an incentive payment.  Failure to report PQRS data in 2014 will result in a 2.0% PQRS penalty through reduction of Medicare physician fee schedule payments in 2016, plus a possible additional 2.0% penalty under the new Value-based Modifier program.

The American College of Radiology (ACR) recently issued a reminder that “It’s not too late to earn an incentive for 2014 PQRS and avoid the 2016 negative payment adjustment.”  In the article published in the January 16, 2015 issue of the Advocacy in Action eNews the ACR points out that radiology groups can still submit the data required to satisfy their 2014 reporting requirement by using a qualified registry such as the PQRSwizard.   The window of opportunity for using the registry closes on February 26, 2015.  The article provides a good summary of the steps required to accomplish this task.

Using the registry is just one of several methods for submitting PQRS data, but it is the only one available for those who did not act in 2014 to use their Medicare Part B claims as the medium for data submission throughout the year.  Going forward, radiology practices will have to consider the pros and cons of the various alternatives available to them in order to avoid fee schedule reductions under both the PQRS program and the associated Value-based Modifier program that will affect groups of 10 or more physicians in 2016 based on performance in 2014, and practices of all sizes beginning in 2017 based on performance in 2015. 

Healthcare Administrative Partners understands the complexities around and impacts of Medicare programs such as PQRS.  It is our goal to continue to provide time-sensitive and actionable information to help your practice maximize your revenue within the scope of this and other programs that will affect your Medicare reimbursement.   Subscribe to this blog to receive the next articles in our series of PQRS related advice for radiology practices which will be published shortly.