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

Why PQRS

• 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

Participation

• 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%