PQRS Reporting for 2015 to Avoid 2017 Adjustment

physical therapy and medicare
January 12, 2015
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CMS has announced the 2015 PQRS reporting requirements necessary to avoid a 2% adjustment (decrease) in Medicare payments in 2017.

While therapists only needed to report on 3 individual measures during 2014 to avoid a 2% adjustment in 2016, the 2015 reporting requirements have been increased to 8 individual measures for physical therapists and 9 individual measures for occupational therapists to avoid a 2% adjustment in 2017. The table below lists these measures and how they can be reported. CMS plans to release the specific reporting requirements for each of these measures at the beginning of 2015 and we will share the details with you as soon as they are available.

You may find that it does not make financial sense to report on 8-9 PQRS measures. We estimate that Medicare effectively pays therapists about $45/hour for time spent complying with PQRS. Given that most groups average at least $100 of revenue per therapist hour, it is hard to justify having therapists spend time reporting during 2015 and receive about $45/hour during 2017.

Alternatively, many physician groups that elect the group practice reporting option (GPRO) and have physicians report applicable PQRS measures either through a registry or EHR satisfy the PQRS requirements on a group wide basis which avoids the 2% adjustment without the need for therapists to report at all.

PQRS Reporting Chart