CMS developed the Physician Quality Reporting System (PQRS), which requires that all eligible Medicare providers—including physical therapists, occupational therapists, and qualified speech therapists—meet criteria for the satisfactory reporting of certain outcome measures. The overall goal of PQRS is to improve the quality of reporting and patient data throughout the healthcare industry, thus reducing claim fraud and optimizing the reimbursement process. Although PQRS is not technically mandatory, eligible professionals who do not meet the reporting requirements are subject to financial penalties. In 2015—and for all subsequent years unless otherwise directed by CMS—that penalty is 2% of total Medicare payments. To comply with PQRS and thus avoid the payment adjustment, rehab therapists must report on a certain number of measures for a designated percentage of eligible Medicare patients. By introducing this initiative, CMS hopes to improve the overall quality of patient data throughout the healthcare industry, which in turn reduces claim fraud and streamlines the reimbursement process.

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