American Speech-Language-Hearing Association

Medicare Releases 2013 PQRS Participation

(April 16, 2014)

Audiologists and speech-language pathologists who submitted Physician Quality Reporting System (PQRS) codes on their 2013 claims can check their participation on the Physician and Other Health Care Professionals Quality Reporting Portal.

Providers can register through the Centers for Medicare & Medicaid Services (CMS) Individuals Authorized Access to the CMS Computer Services (IACS) system to access PQRS Feedback Reports by selecting "Physician Quality Reporting System/eRx." The registration requires a social security number and date of birth to verify the user.

In 2013, Medicare required that every provider of Medicare services-in private or group practice-submit at least one claim for one beneficiary that included PQRS codes; otherwise a 1.5% deduction will be applied to all of the provider's 2015 claims. The portal will allow providers to see if their PQRS participation was recorded, but does not provide the final data analysis for full-year reporting.

Background

PQRS is a required quality reporting system for audiologists and speech-language pathologists (SLPs) who serve Medicare beneficiaries in settings that bill for Medicare services as private or group practices (including ENT offices and university clinics). Participation is tracked through the individual audiologist's or SLP's National Provider Identifier (NPI) that is placed on the claim to identify the provider rendering the service. Medicare requires that all audiology services indicate the NPI of the audiologist performing the service. Speech-language pathology services may be billed "incident to" a physician if the physician is onsite, in which case PQRS reporting requirements would apply to the physician, not the SLP.

In 2014, providers are required to report on a minimum of 50% of their Medicare patient qualifying visits in order to avoid a 2% deduction on claims submitted in 2016.

CMS Resources

ASHA Resources

For additional information, please e-mail reimbursement@asha.org.


Share This Page

Print This Page