The Centers for Medicare and Medicaid Services (CMS) has released final rules for the 2013 Medicare Physician Quality Reporting System (PQRS). Although more emergency physicians participate in PQRS than any other medical specialty, participation is now more important than ever. The 2013 PQRS has four distinct components of incentives and penalties, each with its own distinct criteria applicable to individuals or groups depending on group size.
Explore This IssueACEP News: Vol 32 – No 01 – January 2013
2013 PQRS Measures
Importantly several key ED relevant measures have been eliminated for 2013. These are #57 Emergency Medicine: Community Acquired Pneumonia (CAP): Assessment of O2 Saturation; #58 Emergency Medicine: Community Acquired Pneumonia (CAP): Assessment of Mental Status; #92 Acute Otitis Externa (AOE): Pain Assessment; and #253 Pregnancy Test for Female Abdominal Pain Patients. Please note that due to the retirement of PQRS measures #57 and #58 there is no longer an Emergency Medicine Measures Group for 2013. More detailed specifications for the 2013 PQRS measures are available at: www.cms.gov/PQRS.
2013 PQRS Incentives
In 2013, EPs and group practices that satisfy PQRS reporting requirements are eligible to earn an incentive payment of 0.5 % of total allowed charges. In addition, ABEM diplomates may be eligible to earn an additional incentive payment of 0.5% under the PQRS MOC incentive (www.acep.org/quality/pqrs-moc).
2013 PQRS Penalties
If EPs or group practices do not satisfy PQRS reporting requirements in 2013, a payment adjustment of -1.5 percent will be applied to their total allowable Medicare Part B charges in 2015. Please note that there is a separate, but lower threshold for avoiding the penalties, than for earning the incentive.
For more detailed information on each of the reporting options please go to www.acep.org/quality/pqrs.