tci Medicare Compliance & Reimbursement - 2007 Issue 14

PHYSICIANS: PQRI 'Cap' May Force You To Report More Services

Why you could do everything right and still not receive the 1.5-percent bonus.As paltry as the 1.5-percent bonus for participating in Medicare's quality reporting program seems, even that amount isn't guaranteed to the most spotless participants.The catch: You receive an extra 1.5 percent of all your billings if you report up to three quality measures per claim ...quot; at least 80 percent of the time when those quality measures apply. But Medicare will apply a "cap" that will reduce the 1.5-percent bonus if you only reported relatively few measures, officials from the Centers...

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