Attention Medicare RD Providers:  Are you participating in PQRS?

If you are an RD and Medicare Provider, then hopefully you are familiar with PQRS – the Physician Quality Reporting System that Medicare uses for providers to report quality measure on patients. In the   past, there were payment incentives to participate  but now there are penalties. If you did not report PQRS measures in 2014, there will be a reduction in payments to you from Medicare in 2016. There is a 2 year lag in this process.  Keep in mind if you didn’t do this in 2015, then your payments decrease in 2017. So, if follows that you definitely want to do this in 2016! You must report these on at least 50% of the Medicare patients that you submit claims.   I attended a Webinar recently by Ann Silver, a dietitian in private practice on the ABCS of PQRS and it was very good. Highlights include:

Starting in 2016, unsatisfactory reporting will be a 2% reduction in payment

There are now 4 measures to report on Diabetes patients (not the 5 we did in 2015): 

  1. HbgA1C once per year
  2.  BMI once per year
  3. Elder Maltreatment screen once per year
  4. Medication list once per visit (LDL Cholesterol was taken off so you do not need to report this)

For CRF patients the above applies – if they are not diabetic, then you would not report an A1C.

If all this sounds foreign and you do not want to lose money for the patients you are seeing that have Medicare and you are a Medicare provider, then please go to AND’s website and read all the info on PQRS so you can implement this as soon as possible.   It can be a little confusing and overwhelming so there is a much more thorough explanation as well as “5 Easy Steps on how to Participate” if you log onto, then “Practice,” “Getting Started with Payment,” “Medicare MNT,” “Medicare PQRS.”

To a happy, healthy and prosperous New Year!

Lise Gloede, RD, CDE Owner, Nutrition Coaching LLC VAND Reimbursement Advisor

Lise Gloede, RD, CDE

Owner, Nutrition Coaching LLC

VAND Reimbursement Rep.