PQRS & Measurement

Clinical social workers who are Medicareproviders will be required to participate in MACRA beginning January 1, 2019.

The Centers for Medicare and Medicaid Services is informing clinical social workers who are Medicare Part B providers whether they will be receiving a 2018 Physician Quality Reporting System (PQRS) negative payment adjustment beginning January 1, 2018.

The PQRS officially ended on December 31, 2016. Reports are being issued for the 2016 PQRS reporting period, including negative payment adjustments which will be implemented on January 1, 2018, if appropriate.

It has been brought to NASW’s attention that clinical social workers who are Medicare providers may have inappropriately received notice of a two percent negative payment adjustment in 2017 for not using 9 measures when reporting Physician Quality Reporting System (PQRS) measures in 2015.

The Physician Quality Reporting System (PQRS), which identifies measures available to improve the quality of care provided to Medicare beneficiaries by clinical social workers and other Medicare providers, will end on December 31, 2016. PQRS 2016 payment reports will be made available in 2018 and a negative payment adjustment will be made at that time for those clinical social workers who did not meet the reporting requirements for PQRS 2016.

The Centers for Medicare and Medicaid Services (CMS) has distributed letters to clinical social workers and other Medicare providers regarding the 2017 Physician Quality Reporting System (PQRS) negative payment adjustment.  The letter informs clinical social workers whether they will receive a 2017 negative payment adjustment for not satisfactorily reporting 2015 PQRS quality measures and as a result, will receive a two percent decrease in reimbursement for 2017 Medicare Part B services.