Where Oh Where

We now have a directive and a CMS web site regarding the 1.5% “bonus” or financial incentive for quality reporting.  This was all done under the Tax Relief and Health Care Act of 2006 (TRCHA).

As PT’s we are eligible for a reporting a designated set of quality measures on claims for dates of service from July 1 to December 31, 2007 subject to a cap for covered Medicare physician fee schedule services.  The initiative is for traditional medicare fee-for-service and not applicable to Medicare Advantage Plans.

The website lists 66 quality measures.  None of them are related to outpatient PT.

Just Where Oh Where they are remains to be seen. 

Larry

 

 

Comments

[Selena Horner]

Hold on Larry... we can be somewhat creative. We DO tend to do some of the quality measures.

There was a page with more than 60 indicators... on that particular page -
numbers: 3, 4, 24, 25, 27, 47, 48, 49, 50, 60 are some areas that we could potentially have a role in reporting. Frankly, the majority of those are easy and can easily be captured right within a medical systems review form. It's just a matter of reporting that the quality indicator was assessed or communicated to the physician within the claim form.

Now, there was no indication of how to report or where to report or what to report... I guess that is on the way.

In particular, for our profession, we would have to choose 80% of the time to report 3 of those indicators on our claims... but I think there needs to be clarification - not every claim should have to have the quality indicators - it would make more sense to have them tagged to the claim with the 97001 code. I'm going to assume that the CMS computerized system in analyzing the incoming claims is going to be set to anticipate indicators being reported on every claim when determining whether the 80% reporting threshold criteria was met.