Odds in your favor- Why reporting PQRS as a Group (GPRO) makes sense

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Odds in your favor

Successful reporting of PQRS in 2015 means you will avoid downward adjustment of Medicare payments in 2017 for your physical therapy office. This downward adjustment for not participating in PQRS or reporting less than the minimum requirements, will reduce Medicare payment in 2017 by an estimated 2%.

Physical therapists in an independent practice that have at least two eligible providers have the option of reporting individually or as a group (GPRO.) An important factor in physical therapy office billing, you may be asking yourself “what’s the difference,” or “why you would choose one over the other?” Well there is a big difference and reporting as a GPRO can put the odds in your favor in hitting Medicare’s minimum reporting requirements.

Your next question might be are the minimum requirements for PQRS reporting different if you are reporting individually from reporting as a GPRO? The answer is yes! To successfully report PQRS as individual providers, at least 50% of all eligible providers must meet the minimum requirements. This means if your practice has three therapists on staff, all three providers but successfully hit the 50% benchmark in order to avoid a payment reduction in 2017.

When reporting as a GPRO you must submit your codes through a certified PQRS Registry and you still must successfully report PQRS codes on at least 50% of all eligible Medicare patients in 2015. However, Medicare uses an aggregate rollup of all eligible providers to determine if the minimum requirements are met. This means Medicare looks at your practice as a whole to determine if you successfully reported on at least 50% of eligible Medicare patients. The odds are definitely more in your favor when reporting as a GPRO.

You’re not too late! You have until June 30, 2015 to register online with CMS to indicate your practice will report as a GPRO.

How to Register as GPRO

Registration must be completed through the online PV-PQRS Registration System during the registration period, April 1, 2015 -June 30, 2015. The PV-PQRS Registration System is a web-based application that serves the PV and PQRS programs.

The group practice will need to designate a Security Official (SO) PV-PQRS Role and Representative PV­ PQRS Role to complete registration. Additional information and step-by-step instructions for obtaining PV­ PQRS Roles for registering are available in the “Downloads” section of the Self Nomination/Registration page of the CMS website.

Please use the following information and instructions to register for the 2015 PQRS GPRO:

STEP 1: Go to the PV-PQRS Registration System website. On the right hand side, select Login to CMS Secure Portal.

STEP 2: After accepting the Terms and Conditions, enter your IACS User ID and Password in the Welcome to CMS Enterprise Portal screen. Select Log In to continue.

STEP 3: Select the PV-PQRS tab at the top of the screen, and then select Registration from the dropdown menu.

STEP 4: You will see a screen where the group practice(s) and EP(s) (if applicable) that are associated with your IACS account are listed. To register a group practice for the first time, select the Register link to the right of the group practice you want to register.

Complete information and step-by-step instructions for registering a new group for participation in 2015 PQRS GPRO or for modifying a previous registration is available on the Self Nomination/Registration page of the Medicare FFS Physician Feedback Program/Value-Based Payment Modifier website.

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