Should providers include the Physician Quality Reporting Initiative (PQRI) codes on claims submitted to payers primary to Medicare?
Providers should not include the PQRI codes on claims submitted to primary payers (when Medicare is secondary) unless notified or approved to do so by that payer. Providers should place the PQRI codes on the claim when sent to Medicare for secondary payment in MSP situations. Claims for which Medicare is the primary or secondary payer will be included in the PQRI analysis. PQRI educational materials such as power-point slides, PQRI toolkit materials, measure finder tools, coding manuals and frequently asked questions are posted to the CMS website and are available for download. These materials are continuously being updated to assist you.
Related Questions
- Is it accurate that in 2008 if a therapist participates in the Physician’s Quality Reporting Initiative (PQRI) he/she must report on a minimum of three (3) measures?Yes, that is accurate. Please remember that each of the three (3) measures must meet the 80% threshold?
- What are the financial benefits of participation in the 2009 Physician Quality Reporting Initiative (PQRI)?
- How is the PQRI (Physician Quality Reporting Initiative) part of this incentive to e-prescribe?
