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Policy in Practice: ASCP Provides New PQRS Education Materials for CY 2014

Thursday, January 16, 2014

If you are a pathologist who bills Medicare Part B but has zero applicable Physician Quality Reporting System (PQRS) measures, there’s something you should know:  You will NOT be subject to the -2 percent payment adjustment enforced by the Centers for Medicare and Medicaid Services (CMS) in Calendar Year (CY) 2014!

This is great news that you may not have been aware of during a first glance at the CY 2014 Medicare Physician Fee Schedule (PFS) Final Rule. CMS does not explicitly state this allowance on any recent PQRS education materials made available to the public.  Fortunately, ASCP’s Advocacy team is committed to reading between the lines when analyzing complicated regulations and their potential impact on our members.

Here in the ASCP Advocacy Office, it is our goal to educate our members on relevant policy and provide them with the tools they need to effectively translate that policy into their practice. For this reason, ASCP first informed our members of the changes to both the PQRS and the Value-based Payment Modifier (VBM) program finalized in the CY 2014 PFS Final Rule in our December ePolicy issue.

Now we are providing our members with the following two resources in an effort to guide their selection of the most applicable PQRS reporting option and enhance their understanding of both the PQRS and VBM programs.

Reporting Options Chart

Click here for a Reporting Options Chart, containing the following information for each reporting option available in CY 2014:

  • Specification regarding whether or not the reporting option is available for group and/or individual reporting
  • Specific reporting requirements
  • Registration/ submission timing/process information
  • Additional supplementary information
  • Pathology-specific considerations 
  • Useful accompanying resources

PQRS 101 Document

Click here for our PQRS 101 document, which provides answers to all of your questions as it guides you step by step through successful PQRS reporting and subsequent application of a positive value modifier:

  • Step 1: Understand PQRS and how it impacts you
  • Step 2: Determine whether you are eligible for/exempt from participating in PQRS
  • Step 3: If you are eligible to participate in PQRS, determine whether or not you are required to participate based on whether or not you have applicable measures
  • Step 4: If you have applicable PQRS measure(s), understand the program's registration and reporting requirements
  • Step 5: Assess your reporting options
  • Step 6: Select the reporting option that is best for you and your practice
  • Step 7: Understand how your PQRS participation impacts the application and direction (+/-) of an additional value modifier on Medicare Part B payment amounts under the Value-based Payment Modifier (VBM) Program
  • Step 8: Review your PQRS and VBM performance and identify areas for improvement

*If you have any questions regarding these materials or any questions about PQRS and/or the VBM program in general, please do not hesitate to contact the ASCP Advocacy Office at 202-347-4450.