Getting started in Medicare quality reporting: Resources for practitioners

Psychologists in Medicare must begin participating in the Physician Quality Reporting System (PQRS) in 2013 or face payment penalties later

By Government Relations staff

Dec. 19, 2012—To avoid payment penalties in 2015, psychologists in Medicare who do not yet participate in the Physician Quality Reporting System (PQRS) must begin doing so in 2013. The program, which began in 2007, will switch from awarding bonuses for satisfactory participation to imposing penalties for the failure to successfully report on PQRS measures beginning in 2015.

In 2013 and 2014, psychologists who successfully participate in PQRS will earn an additional 0.5 percent payment on all of their Medicare charges. When the switch to a penalty program occurs in 2015, Medicare will need to analyze reporting data from prior years in order to apply payment adjustments. The 1.5 percent penalty adjustments for 2015 will be based on 2013 reporting data, while the 2 percent penalty for 2016 will be based on 2014 reporting data. Penalties will apply to all Medicare charges by a provider.

Psychologists participating in the program for the first time only need to report one service measure for at least one applicable patient in 2013 in order to avoid penalties later, though the Centers for Medicare and Medicaid Services (CMS) suggests reporting on at least three measures.

The APA Practice Organization has compiled a set of resources on our Practice Central website, including frequently asked questions, 2013 PQRS measures available for psychologists, videos on how to participate in the program, and links to helpful information from CMS. 

Also look for the winter 2013 issue of Good Practice magazine, which should arrive in early January, for more information on participating in the Physician Quality Reporting System, including a complete step-by-step guide for first-time participants.

If you have additional questions, contact your local Medicare administrative contractor or contact Government Relations for the APA Practice Organization by phone at (202) 336-5889 or by email.