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PQRS

The Physician Quality Reporting System (PQRS) is a CMS reporting program that promotes clinical quality action reporting. Eligible professionals (EPs) satisfactorily report data on quality measures provided to Medicare Part B Fee-for-Service patients. ReportingMD has been providing PQRS services since the program’s inception in 2007.

Individual EPs are required to meet the criteria for satisfactory reporting as identified by CMS for a particular reporting year in order to avoid PQRS penalties and VBM downward payment adjustments.

Groups opting to report under the Group Practice Reporting Option (GPRO) for PQRS must register with CMS prior to reporting. Those that file under GPRO are also required to satisfactorily report in order to avoid downward payment adjustments and be eligible for upward payment adjustments.

Key Points for 2015 and 2016

  • No PQRS incentive for Individual EPs or GRPOs
  • Minimum reporting to avoid the penalty includes:
    • 9 individual measures covering at least 3 National Quality Strategy (NQS) domains with at least 1 measure being a cross-cutting measure – reporting on at least 50% of the Medicare Part B patients/events that qualify for each measure (GPRO and Individual EPs) OR
    • 1 measures group – reporting on 20 patients, with at least 11 being Medicare Part B patients (Individual EPs only)
    • Under both options, there must be a positive performance rate of greater than 0.00% for each measure reported to be considered successfully reporting (with the exception of inverted measures)

For more information about PQRS, visit www.cms.gov

To learn more about ReportingMD’s PQRS products and services, click here.