PHYSICIAN QUALITY REPORTING INITIATIVE (PQRI)
Rewarding Providers for Quality Compliance
- The Centers for Medicare & Medicaid Services (CMS) provides financial incentives to physicians and other eligible professionals who satisfactorily report quality data on 153 measures related to covered services provided under the Medicare Physician Fee Schedule34
- The need to provide adequate VTE prophylaxis is a measure that is included in the PQRI34
- Documentation of appropriate VTE prophylaxis ordered, or documentation of VTE prophylaxis not ordered (for medical or other, unknown reason) must be provided34
- Documentation includes a written order, verbal order, or standing order/protocol or other documentation that VTE prophylaxis was given
VTE Measure
VTE Measure and Interpretation
Hip Replacement SurgeryFACT:
For fiscal year 2010, CMS will continue the policy that satisfactory reporting of at least 3 applicable quality measures results in an incentive payment of 2% of estimated allowable charges35-37
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