2014 Proposed Physician Quality Reporting System (PQRS)

There will be no new PQRS measures for 2013 but for the 2014 Physician Quality Reporting System (PQRS) the College of American Pathologists (CAP) has submitted three (3) new measures to qualify for incentive payments. These measures were recently sent to Centers for Medicare and Medicaid Services (CMS):

• Lung cancer (Biopsy/Cytology specimens)
• Lung cancer (resection specimens)
• Melanoma

The Centers for Medicare and Medicaid Services (CMS) will retain the five (5) currently approved CAP-developed pathology measures for the year 2014 PQRS. They are as follows:

• Breast Cancer Resection
• Colorectal Cancer Resection
• Barrett’s Esophagus
• Radical Prostactectomy
• Immunohistochemical (IHC) Evaluation of HER2 for Breast Cancer

The PQRS bonus extends through 2014 and sits at 0.5%.  In addition, for reporting years 2011 through 2014, Eligible Professionals who satisfactorily report can qualify to earn an additional 0.5 percent incentive payment by participating in a Maintenance of Certification (MOC) program and successfully completing a qualified MOC practice assessment.

PQRS Penalty
In 2015, Eligible Professionals who do not successfully report quality data during the designated quality reporting period will be subject to a Medicare fee-for-service payment reduction of 1.5% and rises to 2% in 2016 and each subsequent year.

APS Medical Billing keeps abreast about the never-ending changes and challenges affecting the business of pathology and is always looking for ways to help our clients achieve the best possible financial results. Should you have any questions about PQRS, please contact your Account Manager.