by Madeline Angela Meyer and Michael Alan Meyer, September 19, 2012
PQRS Reporting & Incentives
In 2007, the first year the physician quality reporting system (PQRS) was put into place, there were 74 quality measures. As of September, 2012, the program has over 300 measures. Rules, codes and process for PQRS have changed each year. They will continue to change as the program evolves. New measures come into play, old ones are retired, and incentive rates for participation adjust:
In 2012, there are three reporting methods available to eligible providers participating in PQRS, e.g., claims based reporting during your regular process of submitting Medicare Part B claims to CMS; registry based reporting through a qualified PQRS registries or; electronic health record (EHR) reporting through a qualified EHR product or vendor. What quality measures are reported depends on what method is being used.
For a full picture of the how the new quality measures are reported, see the 2012 PQRS Decision Trees by type of submission process.
CMS. (2010). 2011 2012 Physician Quality Reporting System. January 2012. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/downloads/2012PQRS_SatisfRprtng-Claims_Final508_1-13-2012.pdf
• CMS Physician Quality Reporting website – http://www.cms.gov/PQRS• CMS 2012 PQRS Measure Specifications Manual for Claims and Registry Reporting of Individual Measures (655 pages)– http://www.entnet.org/Practice/qualityimprovement/upload/2012_PhysQualRptg_MeasureSpecificationsManual_122311.pdf
• Medicare and Medicaid EHR Incentive Programs website – http://www.cms.gov/EHRIncentivePrograms • Eligible Professional List for PQRS – http://www.cms.gov/PQRS/Downloads/Eligible_Professionals03-08-2011.pdf
• Eligibility for Medicare EHR Incentive Program – http://www.cms.gov/EHRIncentivePrograms/15_Eligibility.asp#BOOKMARK1
• 2012 Qualified EHR Vendor List – http://www.cms.gov/PQRS/20_AlternativeReportingMechanisms.asp
• 2012 EHR Documents for Eligible Professionals (PQRS Measure Specifications) –
http://www.cms.gov/PQRS/20_AlternativeReportingMechanisms.asp • 2012 Physician Quality Reporting Decision Tree –
• 2012 PFS Final Rule –
http://www.gpo.gov/fdsys/pkg/FR-2011-07-19/pdf/2011-16972.pdf • 2012 EHR Incentive Program Resources for Eligible Professionals –
http://www.cms.gov/EHRIncentivePrograms/55_EducationalMaterials.asp • 2012 EHR Incentive Program Attestation module is available on the CMS website – https://www.cms.gov/EHRIncentivePrograms/32_Attestation.asp
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