2015 PQRS Final Rule

PQRS for 2015 has been simplified slightly, and that is good news for the rehabilitation industry. In 2015, the list of measurements for physical therapy claims-based reporting has been reduced to 6. However, they all need to be reported on 50% of eligible patients. Below is the summary of the final rule and how it impacts TheraOffice users.

Measures eliminated for 2015 reporting period:

  1. 245 – Chronic Wound Care Measure
  2. 148-151 – Back Pain Measure Group

Measures that need to be reported:

  1. 128 Preventative Care and Screening: Body Mass Index (BMI) Screen and Follow Up
  2. 130 Documentation and Verification of Current Medications in Medical Record
  3. 131 Pain Assessment Prior to Initiation of Patient Treatment
  4. 154 Falls: Risks Assessment
  5. 155 Falls: Plan of Care
  6. 182 Functional Outcome Assessment

Frequency of reporting:

Frequency of reporting remains the same as previous years with one significant change. The current medications measure (130) is no longer required when you bill 97110 and 97140. These CPT codes were removed from the requirement, meaning that a typical PT will only have to report these when they bill an evaluation (97001) or re-evaluation (97002).

Claims based reporting:

TheraOffice submits through claim based reporting, which is acceptable at this time. In fact, most PQRS reporting in the US healthcare system is currently claims based. We are looking to migrate towards registry reporting in the future.

TheraOffice:

On December 31, 2014, Hands on Technology will run a PQRS update for TheraOffice Web customers that will remove measurements that will not be used in 2015. At the same time, an add-in will become available within Administrator for our On-Site users. The use of PQRS within TheraOffice will continue to be the same. You will see the PQRS popup and the 6 Measurements when an initial evaluation of an eligible patient is performed. If you bill a 97002 re-evaluation code, you should report again on all measures except for the BMI measure (128).

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