Step by Step Guide for mental health professionals participating in PQRS

1) Confirm that you are a CMS Eligible Professional (EP) here

2) Verify your NPI number via the PECOS website here

3) Choose the PQRS reporting method for your practice: the following steps will show you  the QCDR reporting process;   

4) Determine number of PQRS measures to reporting.   To assess the impact of the number of measures you report, see chart below.

Summary: In 2014 reporting period, the simplest reporting option (I.) has the most impact on your practice's balance sheet with the least amount of record keeping.

4) Identify the most efficient to collect patient data; choose between the following options that works best with your office workflow:

1. CMS-1500 data obtained from your Billing Company / Clearinghouse

2. CMS-1500 data obtained from your Practice Management (PM) or billing software
       CMS-1500 data must include all non financial data, including DOS, CPT/IDT/G codes . . .)

3. Encounter PHI upload from PM or EHR software

4. Encounter PHI entry via web portal form
    

5) Choose scope of PQRS report - A targeted patient population will control the scope of your PQRS submission.  Using a measure with well defined target patient population
characteristics will reduce the number of patient records to be tabulated for your PQRS submission.

General categories of patient target population as defined in PQRS measures: 

1. All patients over age 18
2. All patients over age 65
3. Patients selected by conditions defined in a specific PQRS measure

6) Pre-select the measures you wish to report on: Review the list of measures for Medicare  professionals here and identify which ones match the services you provide. 

7) Verify the associated codes for your preselected measures are present in your records: Do this by using any word processor to search for the CPT/IDT/G codes embedded in your CMS-1500 dataset(s).  Measure worksheets are found in the 2013 PQRS Measures Specification Manual.   Some word processors (and utilities) can count unique words, making it easy to tally the occurrences of particular codes. 

For more information, click on the links below:

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