Physician Quality Reporting System (PQRS)
The Physician Quality Reporting System (PQRS) is a quality reporting program that encourages individual eligible professionals (EPs) and group practices to report information on the quality of care to Medicare. PQRS gives participating EPs and group practices the opportunity to assess the quality of care they provide to their patients, helping to ensure that patients get the right care at the right time.
By reporting on PQRS quality measures, individual EPs and group practices can also quantify how often they are meeting a particular quality metric. Beginning in 2015, the program will apply a negative payment adjustment to individual EPs and PQRS group practices who did not satisfactorily report data on quality measures for Medicare Part B Physician Fee Schedule (MPFS) covered professional services in 2013. Those who report satisfactorily for the 2015 program year will avoid the 2017 PQRS negative payment adjustment.
CMS is pleased to announce the posting of several 2016 PQRS educational materials. Some highlights include:
- The “2016 Implementation Guide,” available on the PQRS How To Get Started webpage, contains information for individual eligible professionals and PQRS group practices participating in 2016 PQRS.
- The 2016 PQRS measures documents, for those reporting via the claims and registry reporting mechanism, are located on the PQRS Measures Codes webpage.
- The 2016 group practice reporting option (GPRO) Web Interface measures documentation is available on the PQRS GPRO Web Interface webpage.
- The PQRS Spotlight webpage contains a list of all recent documents and resources. Please check this page regularly for updates.
Be sure to look at the reporting mechanism-specific pages for “Made Simple” documents as well as other 2016 PQRS information. 2015 PQRS resources will be transferred to a separate webpage following the 2015 submission period.
For questions regarding 2016 PQRS reporting, please contact the QualityNet Help Desk at 1-866-288-8912 (TTY 1-877-715-6222) from 7:00 a.m. to 7:00 p.m. Central Time Monday through Friday, or via e-mail at qnetsupport@hcqis.org.