Dori’s PQRS Picks for 2015

In 2015, I will again report via registry.  So my requirements for picking measures include:  measures that are appropriate for psychologists, measures that are appropriate for my client mix and measures that are available via registry.

All of the claims-based measures are available for registry reporting, so those of you who are reporting via claims can utilize the first section of my picks.  This year there are only 6 (there actually appear to be 7*) measures available for claims-based reporting that are appropriate for psychologists (APAPO, 1/25/15).  You must report on as many of these measures as are appropriate to your patient population to meet Medicare’s criteria for successful PQRS reporting.  Obviously, if you do not work with individual’s over age 65, you would not report on measure # 181, elder maltreatment screen and follow-up plan.  But if you have even one client over age 65 (who is a Medicare FFS recipient),  you must report on measure #181.  The remaining 5 measures are appropriate for every psychological practice. 

Recall that Medicare requires that providers report on 9 measures over the 3 NQS domains on 50% of eligible FFS Medicare recipients.  Since 9 measures aren’t available to psychologists via claims, you will need to report on all 6 available (or 5 if no patients over age 65) measures and will be reviewed via the MAV system (see previous post for description of MAV).  

The 7 measures available for claims based and registry reporting include:

#128 body mass index,

#130 documentation and verification of current medications in the medical record,

#131 pain assessment prior to initiation of patient treatment,

#134 screening for clinical depression, (note that the age for this measure is 12 yrs and up) 

#181 elder maltreatment screen and follow-up plan

#226 preventive care and screening:  tobacco use-screening and cessation intervention

#317 preventive care and screening: screening for high blood pressure and follow-up

Since I will be reporting via registry, I will also be using 3 additional measures to bring my total measures count to 9.   Note that there is an additional measure and measure group that could be used if reporting via registry.  I have chosen not to use those two options because they do not fit my patient population.

The three registry only measures I will be using are:

#173 unhealthy alcohol use

#325 adult major depressive disorder (MDD); coordination of care of patients with specific comorbid conditions

#383 adherence to antipsychotic medications for individuals with schizophrenia.

For additional details about PQRS and these measures, see previous posts.  I will be outlining some of the new measures in subsequent posts.

*Measure #317: Preventive care and screening:  screening for high blood pressure and follow-up appears to be appropriate for psychologists to report.  APA did not include this measure in it’s list, but it does include our CPT codes

Resources:

http://www.apapracticecentral.org

CMS.gov (12/23/14).  PQRS, 2015 measures list.

Blog Author:  Dori Ann Bischmann, PhD

WPA Advocacy Cabinet

 

 

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4 thoughts on “Dori’s PQRS Picks for 2015

  1. Jeremy M Katz

    Hi Dori!

    I believe there is a 7th measure for psychologists who use claims-based submission: No.317 High Blood Pressure Screen & Follow-Up Plan. Applicable CPT codes include 90791, 90832, 90834, 90837 and 90839. Because we will be subject to MAV at the end of the year, it is likely to determine that there was a 7th measure we could have employed and those who did only 6 will be subject to the 2% payment reduction in 2017.

    Does this make sense to you?

    Jeremy

    Reply
  2. Jeremy Katz

    Hi Dori!

    I believe there is a 7th measure for psychologists who use claims-based submission: No.317 High Blood Pressure Screen & Follow-Up Plan. Applicable CPT codes include 90791, 90832, 90834, 90837 and 90839. Because we will be subject to MAV at the end of the year, it is likely to determine that there was a 7th measure we could have employed and those who did only 6 will be subject to the 2% payment reduction in 2017

    Does this make sense to you?

    Jeremy

    Reply
    1. Dori bischmann Post author

      Great catch Jeremy! Neither APA, myself or my PQRS colleagues saw this as being available to psychologists. Yes, it is available to psychologists. The only down side I see is that the BP reading must be taken at the time of the session. BP readings from outside sources cannot be used. Some psychologists are trained to take blood pressure readings and could do it themselves. Other providers who work in facilities could have an aid/nurse take the reading while the provider is present and that reading could then be used. I don’t beleive that you could use a reading that was taken earlier because that would be considered an external source.

      Reply
    2. Dori bischmann Post author

      Another important note about the blood pressure screen measure is that you can not use it for pts that already have an active dx of hypertension. That precludes most of the pts that you and I see. It is meant to identify the onset of high blood pressure as early as possible.
      I don’t think it is a viable measure for my practice and I hope that the MAV does not feel that it is appropriate to all psychologist practices. It might be a good measure for psychologists working with younger pts or even perhaps some of the neuropsychologists depending on their usual population.

      Reply

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