Submit One PQRS Before Dec. 31 to Avoid 2015 Medicare Payment Penalties

By Dr. Jay Henry – Optometrists need to participate in the Medicare Physician Quality Reporting System (PQRS) during 2013 to avoid payment penalties in 2015 on all their Medicare payments. According to the U.S. Centers for Medicare & Medicaid Services (CMS), the requirement to avoid the 2015 payment reduction is a “good faith effort” to participate in the PQRS program.

This “good faith effort” is as simple as using one PQRS code correctly on one Medicare claim during 2013. You do not have to be a “successful” PQRS provider and qualify for the incentive payments to avoid the penalties. It is important that you submit one correct PQRS code on a Medicare patient before the end of the year to avoid the 1.5 percent payment reduction in 2015. If you need further assistance on starting PQRS please visit for help.

E-prescribe Incentive Bonus Available

Optometrists who e-prescribe for Medicare patients with an office visit 25 times during the year can receive a 0.5 percent e-prescribing incentive bonus on all allowable Medicare charges for the year. Report code G8553 on Medicare claims with an office visit to receive credit. You can get the e-prescribing incentive bonus and the PQRS bonus and the Medicaid EHR incentive. The only two you cannot do together are e-prescribing incentive and Medicare EHR incentive.

All ODs should begin e-prescribing if they are not already doing so. It is a core requirement of stage 1 and stage 2 meaningful use, but if they are not ready for meaningful use this is a great way to get their feet wet with using computers for patient care. If they have an EHR they should talk to their vendor and use the integrated e-prescribing. If they do not have an EHR, they should visit NEPSI, which has free e-prescribing for every physician in America.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s