You and your peers would be required to report quality measures for a set minimum number of patients in order to receive a 2% payment bonus under the Physician Quality Reporting Initiative (PQRI) program in 2010, according to CMS's proposed 2010 Medicare Physician Fee Schedule. The agency is planning several other new wrinkles to the voluntary program, including reducing or removing claims-based reporting after 2010 and using electronic health record (EHR) systems to report quality measures.

Download this month's tool from DecisionHealth Professional Services from Part B News' NEW website, www.partbnews.com. The DecisionHealth Professional Services tool for this month is an observation services audit sheet. This form will help you accurately and consistently audit billed observation services. The sheet should be used with chart notes to determine the appropriate service level billed - cutting down on overbilling and ensure compliance.

Our patient had an emergency appendectomy while she was out of state and now our doctor (the patient's primary care physician) is providing follow-up care during the global period. Can we bill for these services?

You can now get paid by Medicare for providing four types of sleep tests for obstructive sleep apnea, according to a recent CMS national coverage determination (NCD). CMS previously allowed carriers to set coverage rules for the tests (G0398-G0400, PBN 7/28/08).

You would have access to 116 current Physician Quality Reporting Initiative (PQRI) measures, 22 new measures, 26 measures eligible for registry reporting and 10 measures eligible for EHR reporting in 2010 under CMS's proposed fee schedule (see main story).

This is a list of the top 10 challenges facing physician practices, as ranked by physicians responding to a 2009 survey by the Medical Group Management Association (MGMA). More than 2,700 physicians took the survey, which asked them to rate 30 different challenges on a five-point scale, with one being "no challenge" and five being "extremely challenging." The highest score averaged just over four, which means the issue is a "considerable challenge."

You can't completely avoid CMS's recovery audit contractors (RACs) even if your practice goes non-par, agency officials tell Part B News. Any assigned claims you file as a non-par provider are fair game for RACs, says Connie Leonard, RAC project officer in CMS's Office of Financial Management.

The 2010 proposed fee schedule proposes two brand new billing opportunities, but both will include complex requirements for you to follow to get paid. CMS wants to cover intensive cardiac rehabilitation (ICR) and pulmonary rehabilitation (PR) programs, two complex physician services intended to treat chronic diseases by modifying patient lifestyles.

The most recent version of a health reform bill under consideration in the House of Representatives would completely revamp the way Medicare pays you and your peers, Part B News has learned. The bill, called the "America's Affordable Health Choices Act of 2009," was introduced July 14 and contains much more detail on changes to physician payment than its counterpart in the Senate, which was released July 15. The House bill would replace the 21.5% cut scheduled for 2010 with a 1% pay boost as a "transitional update."