New PQRI reporting period begins July 1

• 2010 PQRI Implementation Guide

It is not too late to start participating in the 2010 Physician Quality Reporting Initiative (PQRI) and potentially qualify to receive incentive payments, the U.S. Centers for Medicare & Medicaid Services (CMS) is reminding practitioners. A new six-month reporting period begins July 1.

Medicare's PQRI program this year has two reporting periods: a 12-month reporting period that extends from Jan. 1 to Dec. 31 and six-month reporting period that extends from July 1 to December 31.

Eligible health care professionals (EPs) who satisfactorily report PQRI measures during the six-month reporting period will be eligible to receive a PQRI incentive payment equal to 2 percent of their total Medicare Part B allowed charges for services performed during the reporting period.

In previous years, health care practitioners who wished to qualify for PQRI incentive payments were required to report health quality measure over the course of the entire year.

"This year, the addition of a second, shorter reporting period over the second half of the year, effectively gives health care practitioners a second chance to report PQRI quality measures and earn PQRI bonus payments," noted Charles Brownlow, O.D., associate director of the AOA Third Party Center.

Most optometrists participate in the PQRI program through claims-based reporting of individual measures. PQRI claims-based reporting involves the addition of CPT Level II quality-data codes (QDCs) to claims submitted for services when billing Medicare Part B. To qualify for incentives, practitioners must report on at least 3 individual measures (or on each measure if less than 3 measures apply) for 80 percent or more of applicable patients.

Eligible health care professionals do not need to sign up or pre-register to participate in the 2010 PQRI. Submission of QDCs for individual PQRI measures to CMS on Medicare claims will automatically initiate the doctor's participation in PQRI.

Doctors and staff may refer to the AOA Web site for additional information, including a chart of covered measures and coding tips for eye care services and a recorded Webinar.

Although practitioners are not required to register before submitting the data, there are some preparatory steps that eligible professionals should take prior to undertaking PQRI reporting, according to the CMS. For that reason, the agency offers numerous educational products that provide information about how to get started with PQRI reporting, including the 2010 PQRI Implementation Guide.

All of the educational resources can be accessed on the CMS Web site PQRI page (www.cms.gov/PQRI). The CMS encourages eligible professionals to visit the agency's PQRI Web page often for the latest information and downloads on the quality measure reporting program.

AOA members can find additional information on the PQRI program and links to CMS PRQI resources on the AOA Web site PQRI page (www.aoa.org/PRQI). They can also access extensive PQRI information through AOA's free member coding and billing resource, AOA Coding Today.