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PQRS Measure

#134Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan
 Report via: Claim, Registry, EHR, GPRO/ACO, Measure Group
 This measure is can be reported as part of the following groups:
 • Preventive Care Group   
 • HIV/AIDS Group   
 • Dementia Group   
 • Multiple Chronic Conditions Group   

The following codes apply for this PQRS measure:

CPT Codes

CodeModifierPOSDescription
90791Psychiatric diagnostic evaluation
90792Psychiatric diagnostic evaluation with medical services
90832Psychotherapy, 30 minutes with patient
90834Psychotherapy, 45 minutes with patient
90837Psychotherapy, 60 minutes with patient
90839Psychotherapy for crisis; first 60 minutes
92625Assessment of tinnitus (includes pitch, loudness matching, and masking)
96116Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgment, [eg, acquired knowledge, attention, language, memory, planning and problem solving, and visual spatial abilities]), by physician or other qualified health care professional, both face-to-face time with the patient and time interpreting test results and preparing the report; first hour
96118Neuropsychological testing (eg, Halstead-Reitan Neuropsychological Battery, Wechsler Memory Scales and Wisconsin Card Sorting Test), per hour of the psychologist's or physician's time, both face-to-face time administering tests to the patient and time interpreting these test results and preparing the report
96150Health and behavior assessment (eg, health-focused clinical interview, behavioral observations, psychophysiological monitoring, health-oriented questionnaires), each 15 minutes face-to-face with the patient; initial assessment
96151Health and behavior assessment (eg, health-focused clinical interview, behavioral observations, psychophysiological monitoring, health-oriented questionnaires), each 15 minutes face-to-face with the patient; re-assessment
97003Occupational therapy evaluation
99201Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family.
99202Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.
99203Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.
99204Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.
99205Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.
99212Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 10 minutes must be met or exceeded.
99213Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.
99214Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.
99215Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.

HCPCS Codes

CodeModifierPOSDescription
G0101Cervical or vaginal cancer screening; pelvic and clinical breast examination
G0402Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment
G0438Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
G0444Annual depression screening, 5 to 15 minutes
G8431Screening for depression is documented as being positive and a follow-up plan is documented
G8431Screening for depression is documented as being positive and a follow-up plan is documented
G8432Depression screening not documented, reason not given
G8432Depression screening not documented, reason not given
G8433Screening for depression not completed, documented patient or medical reason
G8510Screening for depression is documented as negative, a follow-up plan is not required
G8510Screening for depression is documented as negative, a follow-up plan is not required
G8511Screening for depression documented as positive, follow-up plan not documented, reason not given
G8511Screening for depression documented as positive, follow-up plan not documented, reason not given
G8940Screening for depression documented as positive, a follow-up plan not completed, documented reason
Legend:
ClaimThis measure can be submitted via claim. Use the 'Data Collection' pdf associated with the measure.
GroupThis measure can be submitted through one or more groups. Click on the group name to view the group information.
RegistryThis measure can be submitted through registry.
EHRThis measure can be submitted via Electronic Health Record (EHR).
GPROThis measure can be submitted via Group Practice Reporting Option, or GPRO Web Interface.
SurveyThis measure can be submitted/collected via a Certified Survey Vendor.

More information on these alternative reporting mechanisms is available at:
    http://www.cms.gov/PQRS/20_AlternativeReportingMechanisms.asp.
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