Physician Quality Reporting System (PQRS)
Physician Quality Reporting System (PQRS – Formerly known as the Physician Quality Reporting Initiative or PQRI) – Established by the Centers for Medicare & Medicaid Services (CMS), PQRS uses a combination of incentive payments and downward payment adjustments (penalties) to promote reporting of quality information by eligible professionals. The last year of the financial incentive was 2014, but CMS is still mandated to apply a payment adjustment (penalty) to those eligible professionals who do not satisfactorily report (or do not report) data on quality measures for Medicare Part B services paid under the physician fee schedule. The 2015 PQRS payment adjustment will be assessed using data reported during calendar year 2013, and the data collected for reporting year 2015 will be used for the 2017 payment adjustment.
- Mastering the Basics of PQRS (Coming Soon)
- PQRS Toolkit
- PQRS Instructional Materials – CMS provides a series of free items to increase your understanding of PQRS and your likelihood to succeed. Continuing education credits are available for each course.
- 2015 Physician Quality Reporting System (PQRS) Implementation Guide – Created for old and new participants alike, this CMS informational document explains the basics of PQRS 2015. Learn more about the numerous reporting options as well as measures on which to report.
- Measure-Applicability Validation (MAV) Process – For those unable to report the required nine PQRS Measures (covering at least three domains of care), the Measure-Applicability Validation process is applied. Through the MAV process, CMS determines whether individual eligible professionals (EPs) or group practices have satisfactorily participated in PQRS to the best of their ability. CMS provides an explanation of their process for both claims reporting and traditional registry reporting.
- Reporting Options Made Simple – CMS has issued introductory material to explain the various reporting options. Check on the AUA's Reporting Options summary for links to the CMS materials.
- Physician Feedback, Quality and Resource Use Reports (QRURs) and Value-Based Modifier Program – Overview & Implementation – Beginning in 2017 (and based on 2015 quality reporting), all physicians will be subject to the value-based modifier. Not sure what this is? Check out this CMS bulletin to get details about the program and how it relates to PQRS as well as other useful information.
- PQRSwizard – The 2015 version of PQRSwizard is not yet available. The AUA will post the new version once it has been approved by CMS.
- Value-Based Payment Modifier – The Value Based Payment Modifier (VM) is a quality program, affecting all providers, that is based on cost and quality. The VM program utilizes reported PQRS data along with other information collected and assessed by CMS to either reward or penalize physicians for the quality and cost of care provided.