The Physician Quality Reporting System (PQRS), Medicare’s quality reporting program, ended Dec. 31, 2016. Here’s what you need to know if you’re a Medicare provider.
Why did PQRS end? Under the Medicare Access & CHIP Reauthorization Act (MACRA), the Centers for Medicare and Medicaid (CMS) are required to implement the Merit-Based Incentive Payment System (MIPS) and the use of Advanced Alternative Payment Models to calculate payments to Medicare providers. The transition started in January 2017.
Do psychologists still have to report PQRS measures? PQRS penalties are based on data reported two years before. In January and February 2017, psychologists may use the APAPO PQRSPRO Registry to report 2016 PQRS measures to avoid a 2 percent penalty in 2018.
Psychologists will see a 2 percent penalty applied to their payments in 2017 if they failed to successfully report measures in 2015.
When do psychologists have to begin reporting MIPS quality measures? Psychologists are not required to begin reporting MIPS quality measures until 2019. However, psychologists may voluntarily report MIPS data in 2017 and 2018 in preparation for mandatory reporting.
Will all psychologists have to report MIPS quality measures? Probably not. MIPS contains a low volume threshold that may exempt psychologists. For 2017, practitioners who have $30,000 or less in Medicare charges or treat 100 or fewer Medicare beneficiaries are exempt from reporting under MIPS. These numbers for the low volume threshold may change by 2019.
Where can practitioners report MIPS measures? The APA Practice Organization’s registry, APAPO PQRSPRO, will be available under the name MIPSPRO for psychologists and other clinicians who wish to begin reporting quality measures in 2017 and 2018.
The Practice Organization is working with CMS as it rolls out the new MACRA payment process and will continue to update members during this transition.
Members with questions about PQRS and MIPS can contact government relations staff in the Practice Organization.