PQRI Participation Doesn’t Have to Be Hard

Question: Reporting on PQRI measures seems complicated. Im not sure my office has the time to report. How does our practice register for PQRI reporting, and how much do I have to report to earn my 2 percent payment on Medicare billing?

Michigan Subscriber

Answer: Your practice does not need to sign up or register to take part in the PQRI initiative. Simply send your claims with the correct Category II PQRI tracking codes, and you are part of the program. However, the later you begin, the less money you will be entitled to from the bonus program. The CMS PQRI Web site, www.cms.hhs.gov/PQRI, has additional information.

What you need to report: For claim-based submissions, you have two full-year participation options in 2009:

1. Report at least three PQRI measures (or one to two measures if less than three apply to the eligible professional), for 80 percent of applicable Medicare Part B patients;

2. Or, report all measures in one measure group, documented either for:

" 30 consecutive Medicare Part B fee-for-service (FFS) eligible patients from Jan. 1 through Dec. 31,2009, or

" 80 percent of applicable Part B FFS patients for each eligible professional (with a minimum of 30 patients) during the Jan. 1 through Dec. 31, 2009,reporting period.

For registry-based submission of measures groups,you must report:

" All measures for one measure group for 30 consecutive patients (Patients may include, but may not be exclusively, non-Medicare Part B FFS patients), or

" All measures for one measure group for 80 percent of applicable Medicare Part B FFS patients with a minimum of 30 patients.