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Physician Quality Reporting System

What is PQRS?

  • Voluntary, individual reporting program
    • Quality mesures for service provided to Medicare beneficiaries
  • Started in 2007
    • Tax Relief and Health Care Act
  • Incentive payments awarded through 2014
  • Financial penalty for non‐participation after 2014
  • Measures based on combinations of CPT, ICD and patient age at the time of the encounter


  • Previously allowed incentive incentive payments payments
  • Began payment adjustments in 2015
  • Used to encourage healthcare professionals to report on specific quality measures
  • Providers can compare their performance with their peers helping ensure patients get the right care at the right time


  • By individual individual or group practicies practicies
  • Report data on Physician Fee Schedule for Medicare Medicare Part B Fee‐for‐Service Service
  • Report by:
    • Claims
    • Group Practice Reporting Option
    • Direct from EHR
    • Data Submission Vendor

What to Report

  • Select measures suited to your specialty
  • Clinical conditions commonly treated
  • Preventive, chronic or acute healthcare

Avoid Payment Adjustment

  • Program participation participation during a calendar calendar year will affect payments after two years
  • Report data and quality measures measures in 2015 and avoid a negative payment adjustment in 2017
  • Negative payment adjustment is 2%