Physician Quality Reporting System - PQRS Defined

PQRS – Physician Quality Reporting System

 

PQRS is a  reporting program that uses a combination of incentive payments and payment adjustments to promote reporting of quality information by eligible professionals (EPs). 

The program provides an incentive payment to practices with EPs (identified on claims by their individual National Provider Identifier [NPI] and Tax Identification Number [TIN]). EPs satisfactorily report data on quality measures for covered Physician Fee Schedule (PFS) services furnished to Medicare Part B Fee-for-Service (FFS) beneficiaries (including Railroad Retirement Board and Medicare Secondary Payer). 

Beginning in 2015, the program also applies a payment adjustment to EPs who do not satisfactorily report data on quality measures for covered professional services.  This website serves as the primary and authoritative source for all publicly available information and CMS-supported educational and implementation support materials for PQRS.

 

 

 Physician Quality Reporting System (PQRS) Overview

 

The Physician Quality Reporting System (PQRS) has been using incentive payments, and will begin to use payment adjustments in 2015, to encourage eligible health care professionals (EPs) to report on specific quality measures.

 

Why PQRS

 

PQRS gives participating EPs the opportunity to assess the quality of care they are providing to their patients, helping to ensure that patients get the right care at the right time. By reporting PQRS quality measures, providers also can quantify how often they are meeting a particular quality metric. Using the feedback report provided by CMS, EPs can compare their performance on a given measure with their peers.

Choosing How to Participate

 

The program provides an incentive payment to practices with EPs (identified on claims by their individual National Provider Identifier [NPI] and Tax Identification Number [TIN]), or group practices participating in the group practice reporting option (GPRO) who satisfactorily report data on quality measures for covered Physician Fee Schedule (PFS) services furnished to Medicare Part B Fee-for-Service (FFS) beneficiaries (including Railroad Retirement Board and Medicare Secondary Payer).

 

 

Reporting Methods

 

To participate in the 2013 PQRS program, individual EPs may choose to report quality information through one of the following methods:

1. To CMS on their Medicare Part B claims

2. To a qualified Physician Quality Reporting registry

3. To CMS via a qualified electronic health record (EHR) product

4. To a qualified Physician Quality Reporting EHR data submission vendor

 

EPs should consider which PQRS reporting method best fits their practice when making this decision.

Group practices participating through the Group Practice Reporting Option (GPRO) in the 2013 PQRS program year can self-nominate or register to participate in GPRO via Web Interface or registry reporting depending on the size of their practice. They must elect their reporting method, however, by October 15, 2013. Those who have previously self-nominated may change their selected reporting option before this date.

 

 

For more details contact :

 

HPP – Accuchecker  305-227-2383

psilben@hppcorp.com