Frequently Asked Questions
This is the first in a series of PQRI informational resources for audiologists that will be published by the AQC.
What is the Physician Quality Reporting Initiative (PQRI)?
The PQRI is a voluntary program through the Centers for Medicare and Medicaid Services (CMS) designed to improve the quality of care to Medicare beneficiaries through tracking of practice patterns. Medicare enrolled health care professionals who participate in PQRI by reporting on approved quality measures are eligible for a 2% incentive payment at year end.
Can an audiologist participate in PQRI?
Yes, if the audiologist is enrolled as a Medicare provider. PQRI is for Medicare Part B only, but does not apply to Part B settings for hospitals and skilled nursing facilities.
When can audiologists participate in PQRI?
Beginning January 1, 2010 and through December 31, 2010.
When can an audiologist participating in PQRI anticipate receiving the incentive payment?
After the reporting is calculated for the year.
Are there quality measures that audiologists can report on in 2010?
Yes. Audiologists will be able to report on three quality measures that call for referral of patients of any age to a physician after an audiologic assessment determines one of three conditions and the patient is not currently under the care of a physician for that condition:
- Congenital or traumatic deformity of the ear
- A history of active drainage from the ear within the previous 90 days (for patients who have disease of the ear and mastoid processes)
- A history of sudden or rapidly progressive hearing loss
How would an audiologist report on these three measures?
These measures are reportable via the CMS 1500 claim form. The audiologist would add Medicare directed codes to the claim form to report the measures to CMS.
Why is PQRI important for audiology?
The three audiology PQRI measures were developed by the Audiology Quality Consortium (AQC), a coalition of 10 audiology organizations. By participating in PQRI, audiologists will be providing support for the efficacy of audiology services as part of the patient continuum of care. Participating audiologists are eligible for a 2% incentive payment at year end for performing specific procedures that improve the quality of healthcare.
Where can I find more information?
Further information is available on the Audiology Quality Consortium’s website. Additional information about Medicare the Physician Quality Reporting Initiative can be found on the Centers for Medicare and Medicaid Services (CMS) website.