Physician Quality Reporting System (PQRS)

PQRS is a reporting program that uses a combination of incentive payments and payment adjustments to promote reporting of quality information by eligible professionals (EPs).

The program provides an incentive payment to practices with EPs (identified on claims by their individual National Provider Identifier [NPI] and Tax Identification Number [TIN]). EPs satisfactorily report data on quality measures for covered Physician Fee Schedule (PFS) services furnished to Medicare Part B Fee-for-Service (FFS) beneficiaries (including Railroad Retirement Board and Medicare Secondary Payer).

Immediate Action Needed for Groups with 10 or More Eligible Professionals to Avoid Automatic Medicare Payment Reductions in CY 2016

The deadline for group practices to register to participate in the 2014 Physician Quality Reporting System (PQRS) Group Practice Reporting Option (GPRO) is September 30, 2014 11:59 PM EDT. Group practices with 10 or more eligible professionals can avoid the automatic -2.0% Value Modifier payment adjustment in CY 2016 by participating in the PQRS GPRO in CY 2014 and meeting the satisfactory reporting criteria. If these group practices do not participate in the PQRS GPRO in CY 2014, then they can avoid the automatic -2.0% Value Modifier payment adjustment in CY 2016 if the eligible professionals in the group practice participate in the PQRS as individuals and at least 50% of the eligible professionals meet the requirements to avoid the CY 2016 PQRS payment adjustment. Additional information is available at http://www.cms.gov/PhysicianFeedbackProgram. If you have any questions, please contact the QualityNet Help Desk at 1-866-288-8912 or via email at qnetsupport@hcqis.org.

The PQRS incentive payments are issued annually by the Medicare contractors (Noridian) based on the incentive payment file issued by CMS.

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Last Updated Tue, 12 May 2020 12:18:36 +0000