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Measures

Measures Resources

Sample PQRS Interventional Measure Codes Charge Sheets

The sample PQRS Interventional Measure Codes Charge Sheets (SIR member login required) are intended to serve as a guide to assist. The sample charge sheets list codes for many commonly performed interventional procedures. The codes are by no means all inclusive. It is very important that each practice carefully review the codes and consider others as appropriate. Your feedback is welcome on how these serve as a practice tool: please contact Debbie Ramsburg to share your opinion.

CMS is Accepting Suggestions for Potential PQRS Measures

CMS is accepting quality measure suggestions for potential inclusion in the proposed set of quality measures in the Physician Quality Reporting System (PQRS) for future rule-making years. Quality measures submitted in this Call for Measures may also be considered for use in other quality programs for physicians and other eligible professionals (e.g. Value Based Modifier, Physician Compare, Medicare Shared Savings Program, etc.). The PQRS Call for Measures is now conducted in an ongoing open format, remaining open indefinitely. Measures submitted prior to June 15, 2015 may be considered for inclusion on the 2015 MUC list for implementation in PQRS as early as 2017. Each measure submitted for consideration must include all required supporting documentation. Documentation requirements and the submission timeline are posted on the Measures Management System Call for Measures web page. Questions may be submitted to C4M@wvmi.org.

New Resources: Report Once for Multiple Quality Reporting Programs

New CMS Resources Explain How to Report Once for Multiple Medicare Quality Reporting Programs

Steps to Avoid Negative Payment Adjustments under PQRS and Value Modifier

Physicians who provide Medicare Part B Physician Fee Schedule (PFS) covered professional services need to be aware of negative payment adjustments being implemented in CY 2015. These payment adjustments include:

  1. A negative 1.5 percent payment adjustment under the Physician Quality Reporting System (PQRS) for individual eligible professionals (EPs) who do not submit data on PQRS quality measures to CMS in 2013.
  2. A negative 1 percent adjustment under the Value-Based Payment Modifier (VM) for physicians in groups of 100 or more EPs who submit claims to Medicare under a single tax identification number who fail to report under PQRS in 2013.  

What Do Individual EPs Need to Do?
Individual eligible professionals (EPs) can submit data through the traditional PQRS methods (claims, registry and EHR) to avoid the 2015 payment adjustment and potentially earn a 2013 incentive payment of 0.5 percent. Alternatively, to avoid the payment adjustment only, EPs can request that CMS calculate their quality data from administrative claims. EPs must register for the CMS-calculated administrative claims option by Oct. 15, 2013.
To register for the CMS-calculated administrative claims option, EPs should use the instructions and information available in the Quick Reference Guide for Individual EPs. 
What Do Group Practices Need To Do?
For purposes of the PQRS and VM payment adjustments, group practices should first to identify how many EPs they have billing Medicare under their tax identification number. If the number of EPs in the group is under 100, the group is not subject to the value modifier for 2015. Groups with 2-99 EPs can still register to report under the PQRS Group Practice Reporting Option (GPRO) to avoid the 2015 PQRS payment adjustment and potentially earn a 2013 PQRS incentive payment of 0.5 percent, however it is not required. Groups with 100 or more EPs are required to register for purposes of avoiding a negative VM payment adjustment. Reporting options for group practices include the web-interface GPRO and registry. The reporting option available to the group will depend on the group size. Alternatively, to avoid payment adjustments only, groups can request that CMS calculate their quality data from administrative claims. Group practices must register and select their reporting method by Oct. 15, 2013. 
See the Quick Reference Guide for Group Practices.

Tools For Individual Measures and Measures Groups

Access the tools for individual measures and measures groups online.
Forms for each of the performance measures of interest to interventional radiology are available for download below. 
Some existing measures believed to be relevant to IR have been identified. But, each practice will need to determine the applicability and utility of these measures.