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January 25, 2018

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Medical Coding News Archives

Physician Final Rule Expands Quality Reporting, Increases Incentives

November 11, 2008:

The final rule for the Medicare physician fee schedule has greatly expanded the Physician Quality Reporting Initiative for 2009.

The rule was released on October 30, 2008. It includes the following changes:

Increase in the reporting incentive payment: The payment will go from 1.5 percent to 2.0 percent of the allowed charges for all covered services under the program for calendar years 2009 and 2010.

Increase in the number of measure groups that can be reported: The number will go from the current three to a total of nine. For 2009, the seven  measure groups that can be reported are:

  • Diabetes mellitus*
  • Chronic kidney disease*
  • Preventive care*
  • Coronary artery bypass graft surgery
  • Rheumatoid arthritis
  • Perioperative care
  • Back pain

*valid measure groups for 2008

Making reporting quality measures and meeting bonus thresholds easier: These efforts include the six- and 12-month reporting periods and the testing of electronic health record quality data submission.

Expansion of the number of quality measures: The number of measures will rise from 111 to 153 in 2009.

The final rule also implements the new Electronic Prescribing (E-Prescribing) Incentive Program authorized under the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA). This program allows a provider to receive a 2 percent incentive payment if the professional meets the program requirements for being a successful e-prescriber. In 2009, requirements include the reporting of a quality measure related to the use of e-prescribing technology.

Deborah C. Hall
Clinical/Technical Editor


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