PQRS & Measurement

This document discusses individual PQRS measures used by clinical social workers in solo practice and those who are in a group practice who have individual National Provider Identification (NPI) numbers and retain their billing rights. It also includes small group practices that employ clinical social workers who are rendering providers and have reassigned their billing rights to the group practice.

During 2014, clinical social workers who are Medicare providers should demonstrate quality care by reporting the Physician Quality Reporting System (PQRS) or receive a two percent penalty in 2016 for not using PQRS. The penalty increases each year PQRS is not used. PQRS identifies measures that may be used by clinical social workers to improve the quality of care provided to Medicare beneficiaries.

The Tax Relief and Health Care Act of 2006 identifies clinical social workers as eligible professionals to participate in the Physician Quality Reporting System (PQRS). Participating in PQRS 2014 increases clinical social workers’ practice revenue by .5 percent. In addition, successful reporting of PQRS allows clinical social workers to avoid a two percent penalty in 2016 for not using measures in 2014.

NASW would like hear from clinical social workers who have a certificate in applied behavioral analysis and treat patients who have the diagnosis, Autism Spectrum Disorder. 

Clinical social workers who are Medicare providers should participate in the 2013 Physician Quality Reporting System (PQRS).  Participation increases practice revenue by .5 percent and avoids a 1.5 percent penalty in 2015 for not using measures in 2013.

NASW encourages clinical social workers who are Medicare providers to participate in the 2013 Physician Quality Reporting System (PQRS). Doing so not only increases practice revenue by .5 percent, but helps clinical social workers avoid a 1.5 percent penalty in 2015 for not using measures in 2013.