QCDR QPP Guide for Psychologists

Psychiatrists have a doctorate (Phd) degree and, in some states, can prescribe psychotropic (psychiatric) medication; this professional usually deals with people with greater psychopathology (schizophrenia, bipolar disorder, severe depression & anxiety) or those who prefer not to engage in therapy.

Since some psychologists can prescribe medication and greater psychopathology, there are several QPP measures that provide meaningful metrics for the various facets of psychiatric medications that can be prescribed.

Q: Note that Measure #9 involves reporting on patients who are suffering from Major Depressive Disorder and have been prescribed, or at least evaluated for the use of antidepressant medication. How can psychologists who lack the authority to prescribe report on a measure that involves medication?

    Step by Step Guide for participating in QPP 2016

1) Determine the primary reporting method for your practice: It is advantageous to use the QCDR report method described here.

for reporting QPP data; for example, you can report via claims and QCDR,

2) To improve your chances for a favorable QPP report outcome, you can continue to use a legacy report method is via claims-based reporting; You continue to simply add a G-codes to the claim that you currently submit to Medicare.  CMS will utilize the reporting method most advantageous to the reporting provider. 

2) Pick measures to report on: see the list of available measures below and find which ones match the services you provide.  For the 2016 reporting period, CMS suggests you report on at least nine measures, but as long as you report on at least one measure in 50 percent of the applicable cases you may be eligible for avoiding the penalty.  You can report 1-8 measures if less than 9 are applicable to your practice.

3) Find the correct CPT code(s): the CPT (billing) codes for mental health change annually, so be sure to use the correct code for the service provided for the report year. 

4) Use the appropriate G code: G codes are used to indicate what action, if any, was taken.  Because QPP is a reporting program, not pay-for-performance, providers may report that they did not provide the action specified under the measure and still qualify for bonus payments (or meet the minimum criteria and avoid penalties).  Details about G codes can be found in the measure worksheets of the QPP specifications manual.

QPP Available Measures for Psychologists

• Major depressive disorder: antidepressant medication during acute phase for patients with MDD (#9)

• Major depressive disorder: diagnostic      evaluation (#106)

• Major depressive disorder: suicide risk      assessment (#107)

• Preventive care and screening: Body mass index      screening and follow-up (#128)

• Documentation and verification of current      medications in the medical record (#130)

• Pain assessment prior to initiation of patient      therapy and follow-up (#131)

• Screening for clinical depression and      follow-up plan (#134)

• Preventive care and screening: Unhealthy      alcohol use—screening (#173)

• Elder maltreatment screen and follow-up plan      (new measure effective in 2009)

• Preventive care and screening: Tobacco use      assessment and tobacco cessation intervention (#226)

• Substance use disorders – counseling (#247)

• Substance use disorders – Screening for      depression (#248)

• Adult Major Depressive Disorder (MDD):      Coordination of Care of Patients with Specific Comorbid Conditions (#325)

CUHSM.org is a QCDR registered with CMS that provides QPP support to therapist.   We streamline the QPP reporting process by providing alternative methods that integrate with the CMS billing workflow of providers, especially for those (like many therapists) who do not use an EHR:

Please click on the links below for more information.

 

See the sidebar links here for details about each reporting method.