Pina C. Sanelli
The Physician Quality Reporting System (PQRS) has been using incentive payments, and will begin to use payment adjustments in 2015, to encourage eligible health care professionals to report on specific quality measures. It is important to be aware that beginning in 2015, the program will apply a payment adjustment to physicians and/or groups who do not satisfactorily report data on quality measures for covered professional services during the 2013 PQRS program year. Physicians and/or groups who do not participate in 2013 and receive a payment adjustment will be paid 1.5% less than the Medicare Physician Fee Schedule (PFS) amount for services provided in 2015.
Participating in the PQRS program gives an opportunity to radiologists to assess the quality of care they are providing to their patients. By reporting PQRS quality measures, physicians and/or groups also can quantify how often they are meeting a particular quality metric. In 2013, physicians and/or groups have the opportunity to earn the PQRS incentive and an additional incentive of 0.5% by working with a Maintenance of Certification (MOC) entity, such as the American Board of Radiology. To qualify for the additional incentive payment, physicians and/or groups must satisfactorily submit PQRS data for a 12-month reporting period, either as an individual physician or as a member of a selected group practice and participate more frequently than is required to qualify for or maintain board certification.
New this year, a measure group has been developed in optimizing patient exposure to ionizing radiation (OPEIR) including the following measures for 2014:
#359 – Utilization of a Standardized Nomenclature for Computed Tomography (CT) Imaging Description
#360 – Count of Potential High Dose Radiation Imaging Studies: Computed Tomography (CT) and Cardiac Nuclear Medicine Studies