ACP noted that CMS made a series of modifications that resulted in a dramatic reduction in both the number of relevant measures and the administrative burden associated with submitting data. ACP termed these revisions in the PVRP as being "critically important" and "essential" for the success of the quality improvement program.
Last fall, CMS advanced the PVRP with 36 measures 22 of which were applicable to internal medicine specialists and subspecialists. ACP contended that because each of the CMS measures had a minimum of three potential G-codes, physicians and their staff would need to be familiar with as many as 39 potential codes for the 12-13 measures that might need to be reported for a 70-year-old woman with diabetes, coronary artery diseases and osteoporosis a constellation of conditions that is not terribly uncommon in many practices.
ACP also recommended that CMS consider the use of CPT II codes when available, because commercial payers do not typically accept G-codes (G codes are Medicare-specific codes that are typically used by the program for reporting services under conditions that are unique or particular to the Medicare program, and therefore are generally not recognized by other payers). Physicians will be forced to report differently on the same measures for commercial payers if G-codes are the only option.
Over the past several months, ACP has had continued and positive discussions with CMS on how to improve the PRVP. Consistent with ACP's
Contact: David B. Kinsman, APR
American College of Physicians