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Comprehensive Primary Care Plus Updates                                      May 7, 2020

Supplemental Data and Category II CPT Codes

Performance on quality measures is based largely on claims data, but supplemental data may be submitted as well. Some examples are:
  • Medical records of a member who had a colonoscopy before enrolling with QualChoice.
  • Removal of a total hysterectomy patient from the cervical cancer screening measure.
To send additional data, complete the Supplemental Data Submission Form available on the My Account portal at QualChoice.com.

Category II CPT codes may also be submitted for reporting of quality data. Note: Category II codes must be submitted as eCQMs for these measures:
  • Controlling Blood Pressure
  • HbA1c Poor Control
  • Tobacco Use
The last chance to improve your 2019 quality metrics through supplemental
data and Category II CPT codes is  June 15, 2020 . For questions, email: 

Updated Reports

Quality and Utilization reports with data through 2019 have been published to the CPC+  My Account portal at QualChoice.com. An updated Gaps in Care report including data through April 2020 has also been published. Please check the portal and download to review.

Training Deck Update

The CPC+ Participating Provider Training deck is being updated to reflect changes to the program. Check the My Account portal or Value-Based Care Program page at QualChoice.com.

COVID-19 Coverage and Payment Policies

Through June 30, and extended as necessary, QualChoice will implement revised provider payment rules for fully insured group plans. Complete provider information can be found in the COVID-19 Information Center at QualChoice.com, under the
For Providers tab.

Note: We recognize that the interruption in routine and preventive medical services during the COVID-19 pandemic may impact CPC+ quality metrics. No provider or practice will be penalized for failing to provide preventive services during this timeframe. The calculation of performance on quality metrics will be adjusted to account for these extenuating circumstances.

QualChoice Health Insurance
 800.235.7111  | newseditor@qualchoice.com  | QualChoice.com

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