Physician Quality Reporting System (PQRS)
The Centers for Medicare & Medicaid Services (CMS) has made some significant changes to the 2014 PQRS program. The PQRS Toolkit was created to help you understand these changes and successfully participate.
Some things to note about 2014 PQRS:
- This is the last year to possibly earn an incentive (+0.5 %).
- The data reported in 2014 will be used to assess the 2016 payment adjustment (penalty) for incorrectly or not reporting. The penalty will be -2 %.
- If you wish to earn the incentive and are using individual measures either through claims or registry reporting, you must report 9 measures (which must include at least 3 different domains of care).
- If you wish to solely avoid the penalty and are using individual measures either through claims or registry reporting, you must report at least 3 measures. You will not be eligible for an incentive.
- Additional reporting options have been added.
For complete information and to view an updated list of frequently asked questions, visit the Centers for Medicare & Medicaid Services (CMS) PQRS website.
You may contact the AUA with your questions at PQRS@AUAnet.org.
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AUA Resources
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Measure Specifications
- Measure# 20 – Perioperative Care, Timing of Prophylactic Parenteral Antibiotic – Ordering Physician [pdf]
- Measure# 23 – Perioperative Care, Venous Thromboembolism (VTE) Prophylaxis (When Indicated in ALL Patients) [pdf]
- Measure# 30 – Perioperative Care, Timing of Prophylactic Antibiotic – Administering Physician [pdf]
- Measure# 46 – Medication Reconciliation [pdf]
- Measure# 47 – Advance Care Plan [pdf]
- Measure# 48 – Urinary Incontinence, Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older [pdf]
- Measure# 49 – Urinary Incontinence, Characterization of Urinary Incontinence in Women Aged 65 Years and Older [pdf]
- Measure# 50 – Urinary Incontinence, Plan of Care for Urinary Incontinence in Women Aged 65 Years and Older [pdf]
- Measure# 102 – Prostate Cancer, Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients [pdf]
- Measure# 104 – Prostate Cancer, Adjuvant Hormonal Therapy for High Risk Prostate Cancer Patients [pdf]
- Measure# 110 – Preventive Care and Screening, Influenza Immunization [pdf]
- Measure# 113 – Colorectal Cancer Screening [pdf]
- Measure# 119 – Diabetes, Medical Attention for Nephropathy [pdf]
- Measure# 128 – Preventive Care and Screening, Body Mass Index (BMI) Screening and Follow-Up [pdf]
- Measure# 130 – Documentation of Current Medications in the Medical Record [pdf]
- Measure# 131 – Pain Assessment and Follow-Up [pdf]
- Measure# 173 – Preventive Care and Screening, Unhealthy Alcohol Use – Screening [pdf]
- Measure# 194 – Oncology, Cancer Stage Documented [pdf]
- Measure# 226 – Preventive Care and Screening, Tobacco Use, Screening and Cessation Intervention [pdf]
- Measure# 236 – Controlling High Blood Pressure [pdf]
- Measure# 265 – Biopsy Follow-Up [pdf]
- Measure# 317 – Preventive Care and Screening, Screening for High Blood Pressure and Follow-Up Documented [pdf]
- Measure# 358 – Patient-centered Surgical Risk Assessment and Communication [pdf]
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Measure Flowcharts
- Measure Flow Chart# 20 Perioperative Care Timing of Prophylactic Parental Antibiotic-Ordering Physician [pdf]
- Measure Flow Chart# 23 Perioperative Care Venous Thromboembolism (VTE) Prophylaxis (When Indicated in ALL Patients) [pdf]
- Measure Flow Chart# 30 Perioperative Care Timely Administration of Prophylactic Parenteral Antibiotics [pdf]
- Measure Flow Chart# 46 Medication Reconciliation [pdf]
- Measure Flow Chart# 47 Advance Care Plan [pdf]
- Measure Flow Chart# 48 Urinary Incontinence Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older [pdf]
- Measure Flow Chart# 49 Urinary Incontinence Characterization of Urinary Incontinence in Women Aged 65 Yrs and Older [pdf]
- Measure Flow Chart# 50 Urinary Incontinence Plan of Care for Urinary Incontinence in Women Aged 65 Yrs and Older [pdf]
- Measure Flow Chart# 102 Prostate Cancer Avoidance of Overuse of Bone Scan for Staging Low-Risk Prostate Cancer Patients [pdf]
- Measure Flow Chart# 104 Prostate Cancer Adjuvant Hormonal Therapy for High-Risk Prostate Cancer Patients [pdf]
- Measure Flow Chart# 110 Influenza immunization [pdf]
- Measure Flow Chart# 113 Preventive Care and Screening Colorectal Cancer Screening [pdf]
- Measure Flow Chart# 119 Diabetes Mellitus Medical Attention for Nephropathy [pdf]
- Measure Flow Chart# 128 Preventive Care and Screening Body Mass Index (BMI) Screening and Follow-Up [pdf]
- Measure Flow Chart# 130 Documentation of Current Medications in the Medical Record [pdf]
- Measure Flow Chart# 131 Pain Assessment and Follow Up [pdf]
- Measure Flow Chart# 173 Preventive Care and Screening Unhealthy Alcohol Use Screening [pdf]
- Measure Flow Chart# 194 Oncology Cancer Stage Documented [pdf]
- Measure Flow Chart# 226 Preventive Care and Screening Tobacco Use Screening and Cessation Intervention [pdf]
- Measure Flow Chart# 236 Controlling High Blood Pressure [pdf]
- Measure Flow Chart# 265 Biopsy Follow-Up [pdf]
- Measure Flow Chart# 317 Preventive Care and Screening Screening for High Blood Pressure and Follow-Up [pdf]
- Measure Flow Chart# 358 Patient Centered Surgical Risk Assessment and Communication [pdf]
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Helpful tools for PQRS
Sample Order Forms and Questionnaires
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ARCHIVED toolkits
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OTHER Resources
CMS
- CMS 1500 Claim [pdf]
- CMS QualityNet Help Desk
Phone: 866-288-8912
Email: QNetsupport@hcquis.net
American College of Surgeons (ACS)