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Avoiding Payment Reductions

Coding Corner

The information provided here applies to Medicare coding. Be sure to check with your Medicare Administrative Contractor (MAC) for additional information and clarification on these and other items. You should also contact your local insurance carriers to determine if private insurers follow Medicare's lead on all coding matters.

Avoiding Payment Reductions
Physicians who provide Medicare Part B professional services should be aware of a 1.5 percent payment reduction under the Physician Quality Reporting System (PQRS) for individual eligible professionals (EPs) who do not submit data on PQRS quality measures to CMS in 2013. The payment reduction will be implemented in calendar year 2015. EPs can submit data through the traditional PQRS methods (claims, registry and EHR) to avoid the 2015 payment adjustment and potentially earn a 2013 incentive payment of 0.5 percent. Additional information is available at www.cms.gov/Medicare.... You can also contact CMS’ QualityNet Help Desk at 1-866-288-8912 or by email at gnetsupport@sdps.org.