Now Available: ACR’s Guidance for Reporting CMS Quality Measures
Radiologists are now able to report quality measures and qualify for up to a 1.5 percent bonus, under the Physician Quality Reporting Initiative (PQRI) by the Centers for Medicare and Medicaid Services (CMS). To make PQRI reporting as simple as possible, the ACR has prepared its 2007 PQRI Guidance for Reporting.
To qualify for a bonus under the PQRI program, two quality measures must be reported by diagnostic radiologists (numbers 10 and 11), and two quality measures must be reported by radiation oncologists (numbers 71 and 74).
Interventional radiologists may have up to seven quality measures relating to their scope of practice (numbers 20 -24, as well as numbers 10 and 11), of which at least three must be reported to qualify for the bonus.
Provided in the ACR PQRI reporting guidance are bonus qualification details, including CMS’s minimum reporting requirements and how the bonus is calculated. The maximum bonus available is 1.5 percent of total allowable Medicare billings for claims submitted with dates of service during the last six months of 2007 (the period that the PQRI is in operation).
Participation in the PQRI is voluntary and is triggered by submission of claims to Medicare carriers, which include CPT®, ICD-9, and special CPT-II quality codes that meet CMS specifications for each of the above four quality measures. The coding specifications for these measures can also be found in the ACR PQRI reporting guidance.
The guidance provides:
- Simple instructions for filling out claims
- Codes needed for PQRI reporting
- Links for easy-to-use “PQRI data collection sheets”
All will help to ensure that the right patients, diagnoses, and procedures are identified and placed on PQRI eligible claims. The guidance also provides sample successful reporting scenarios.
Click here for more details on CMS’s PQRI program.
Additional information on ACR’s and CMS’s Pay-for-Performance initiatives can be found in the Pay for Performance section of the ACR Web site.