About PQRS – What you need to know to be paid for the chiropractic services you provide for Medicare patients

In the recent video hangout conversation between ChiroSecure and Dr. Sam Collins, Director of the H.J Ross Chiropractic and American Acupuncture Council Insurance Information Network, they spoke about PQRS or Physician Quality Reporting System. They highlighted some important facts that chiropractic practitioners should know in order to be paid for the service rendered to Medicare patients. Here are some of the main points from the discussion:

What is PQRS?

  • The PQRS is a reporting program that requires doctors enrolled in Medicare (Participating or Non-Participating providers) to submit data on the reporting of specified quality measures.
  • PQRS is needed when treating Medicare patients so you can stay in compliance
  • PQRS is not mandatory; however, this has been highlighted in the industry because recently lots of doctors received a letter from Medicare stating that their fees were reduced by 2% since they were not compliant
  • Though RQRS is technically not mandatory, the Patient Protection and Affordable Care Act (PPACA) mandated that Medicare is required to adjust payments for providers who do not participate in PQRS.
  • PQRS can be done without electronic records
  • Medicare Federal law requires that covered services performed to a Medicare patient must be billed. The only provider that can bill the covered services is a registered provider.
  • Chiropractors need not to undergo any registration process but simply report the performance of the measure on the 1500 form along with their chiropractic services
  • Measures that chiropractors need to do for compliance (there are only 2): (1) Measure 131 – for pain assessment and follow-up; (2) Measure 182 – functional outcome assessment

Verifying your compliance

  • A provider can simply call their A/B MAC to request the PQRS feedback report, which will contain information based on their individual NPI (if the provider is part of a group practice, each provider in the group practice must submit individually).
  • Providers can logon the secure PQRS Portal on Quality Net at: https://www.qualitynet.org/portal to access their feedback report.
  • Questions or who need assistance should contact the Quality Net Help Desk at: 1-866-288-8912 (Monday-Friday 7:00 a.m. – 7:00 p.m. CST) or email Qnetsupport@hcqis.org

Watch the full video hangout below to learn more important insights about PQRS for chiropractors:

YouTube player

For more questions on PQRS, send us a message here at ChiroSecure – your chiropractic liability insurance provider.

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