PQRS for Audiologists

November 05, 2012

PQRSThe Centers for Medicare and Medicaid Services (CMS) has designed the Physician Quality Reporting System (PQRS) to track practice patterns and thereby improve the quality of care to Medicare beneficiaries.

If you bill outpatient Medicare Part B beneficiaries, you must begin participating in the Medicare PQRS by 2015, or portions of the claims paid to you as a Medicare provider will be reduced.

However, there is also an incentive for audiologists who begin reporting using the PQRS now. Through December 31, 2014, a 0.5% bonus will be given when you report on a minimum of three measures for all eligible cases.

Reporting is relatively simple. Whenever you perform an eligible CPT code, determine whether or not there is a corresponding G code and report it on the CMS 1500 claim form. If the CPT code is reported with the ICD-9 code, the appropriate G-modifier code must appear on the claim in box 24D.

For more information, we have compiled the following resources:

From the Audiology Quality Consortium: Reporting Audiology Quality Measures: A Step-by-Step Guide

From the Academy of Doctors of Audiology: Frequently Asked Questions


From the Centers for Medicare and Medicaid Services: Physician Quality Reporting System


From the American Speech-Language-Hearing-Association: Physician Quality Reporting System FAQs


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