An important paper has been released by the U.S. Hyperbaric Oxygen Therapy Registry (HBOTR) detailing its work in Medicare reimbursement issues.
“Rapid analysis of hyperbaric oxygen therapy registry data for reimbursement purposes,” a technical paper by Caroline E. Fife, Helen Gelly, David Walker and Kristen Allison Eckert is available as an epub-ahead-of-print download to members of the Undersea and Hyperbaric Medical Society. Just log in and go to:
Jointly sponsored by the UHMS and the US Wound Registry (USWR), the HBOTR recently provided national data quickly to the RUC on thousands of patients who underwent HBO2 in order to help establish a fair analysis of the physician work of hyperbaric chamber supervision.
Medicare reimbursement rates for all physician services are established via a complex methodology utilizing data provided by the American Medical Association (AMA)/Specialty Society Relative Value Scale Update Committee (RUC), which values the “relative work” and practice expense of CPT codes and makes recommendations regarding valuations to the Centers for Medicare and Medicaid Services (CMS).
The authors note: “It is vital that hyperbaric practitioners engage in registry submission if they are to survive the titanic shift in healthcare payment reform under MACRA (Medicare Access & Chip Reauthorization Act of 2015).”
Participation in a Qualified Clinical Data Registry (QCDR) can satisfy the requirement for specialty registry participation under “Meaningful Use” of an Electronic Health Record. In addition, many Clinical Practice Improvement Activities, which are 15% of the provider’s total score in MACRA’s Merit Based Incentive Payment System (MIPS) require QCDR participation. Additionally, hyperbaric practitioners who report quality measures through the HBOTR can earn bonus points for the Quality Reporting portion of MIPS (50% of the total score), particularly if they report safety, appropriate use, or outcome quality measures. While no such hyperbaric measures are available in the Physician Quality Reporting System, the UHMS developed hyperbaric safety, outcome, and appropriate use measures in partnership with the USWR, which can be reported through that QCDR and whose data become part of the HBOTR.
To read the paper in its entirety, go to: https://www.uhms.org/publications/uhm-journal/uhm-journal-ahead-of-print.html
Caroline Fife, MD
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