CMS Physician Quality Reporting System (PQRS)
Bonuses available now, but you must start reporting in 2013 to avoid a penalty in 2015.
|2012||0.5% if no MOC; 1% if MOC*|
|2013||0.5% if no MOC; 1% if MOC*|
|2015||-1.5% if no successful reporting for 2013|
*The only PQRS-Maintenance of Certification (MOC) module from the American Board of Family Medicine is diabetes.
The AAFP offers a discount for members who use the PQRIWizard registry offered by CECity.
- Earlier referred to as Physician Quality Reporting Initiative (PQRI)
- Requires both NPI and Tax ID #
- Pay-for-reporting, not pay-for-performance
- Initially required CPT II or “G” codes along with billing codes on claims; now there are four ways to participate
- Registry participation is the most promising path for small- and medium-sized practices
- PQRS is not a substitute for local quality improvement efforts
PQRS Reporting Options
- Medicare Part B claims-based reporting (CPT II or G codes)
- Reporting to a CMS-approved registry (PQRIWizard is one option)
- Via qualified electronic health record product
- EHR data reporting through a qualified Physician Quality Reporting data submission vendor
A list of CMS qualified registries for 2012 (25-page PDF file; About PDFs) is available on the CMS web site.
For claims reporting: A 2012 Physician Quality Reporting System (PQRS) Toolkit is now available on the AMA web site. These tools include a description, specifications and data collection sheet for all PQRS claims measures, as well as links for the individual measures or measures groups.