2013 Physician Quality Reporting System (PQRS)

 2013 Physician Quality Reporting System (PQRS):

 

 The Physician Quality Reporting System (PQRS) is a voluntary reporting program that provides an incentive payment to identified eligible professionals who satisfactorily report data on quality measures for covered Physician Fee Schedule (PFS) services furnished to Medicare Part B Fee-for-Service (FFS) beneficiaries (includes Railroad Retirement Board and Medicare Secondary Payer).

 Beginning in 2015, the program also applies a payment adjustment to eligible professionals who do not satisfactorily report data on quality measures for covered professional services.

 

Electronic Health Record Reporting

Beginning with the 2010 Physician Quality Reporting System (PQRS) program year, eligible professionals may qualify to earn a PQRS incentive through the Electronic Health Record (EHR)-based reporting method.  Eligible professionals (EPs) have the following EHR-based reporting options:

1.     Submit PQRS quality measure data directly from their EHR system.  EPs who choose to report on EHR measures must report on a minimum of three measures for Medicare Part B beneficiaries at an 80 percent reporting rate to be able to qualify to earn a PQRS incentive payment.  Please refer to the relevant program year EHR Documents for EPs zip file for a list of measures available for reporting.  EPs participating in PQRS utilizing a qualified EHR Direct product should contact the qualified EHR Direct Vendor for additional details on submission.

2.     Submit PQRS quality measure data extracted from their EHR to a qualified EHR Data Submission Vendor. The EHR Data Submission Vendor would then submit the PQRS measures data to CMS in the CMS-specified format(s) on the EP’s behalf.  EPs who choose to report on EHR measures must report on a minimum of three measures for Medicare Part B beneficiaries at an 80 percent reporting rate to be able to qualify to earn a PQRS incentive payment.  Please refer to the relevant program year EHR Documents for EPs zip file for a list of measures available for reporting.  EPs participating in PQRS utilizing a qualified EHR Data Submission Vendor should contact the qualified EHR Data Submission Vendor for additional details on submission.

3.     Submit quality measure data through the PQRS-Medicare EHR Incentive Program Pilot which uses specific 2012 PQRS EHR measure specifications.  EPs participating in the Pilot are required to submit information on three core measures. If the denominator for one or more of the core measures is zero, the EP must report on up to three alternate core measures. EPs must also report on three additional measures available for the Medicare EHR Incentive Program. Please refer to the 2012 PQRS-Medicare EHR Incentive Pilot Quick-Reference Guide for a list of the core, alternate core and additional measures available for reporting.

 

More information & downloads available at cms.gov website.