CMS Physician Quality Reporting System (PQRS)

PQRS and Your Practice

Bonuses & Future Penalties
Bonuses & Future Penalties: 2013 0.5 % if no MOC; 1% if MOC*
Bonuses & Future Penalties: 2014 0.5%
Bonuses & Future Penalties: 2015 -1.5% if no successful reporting for 2013
Bonuses & Future Penalties: 2016 -2%

*The only PQRS-Maintenance of Certification (MOC) module from the American Board of Family Medicine is diabetes.

AAFP PQRI Wizard

Quality measures reporting is easy with PQRI Wizard(aafp.pqriwizard.com), a simple and cost-effective online tool that collects and reports quality measures data under the CMS PQRS incentive payment program.

Use PQRI Wizard(aafp.pqriwizard.com) to organize clinical data and to help provide evidence-based care to your patients.

PQRS

  • Earlier referred to as Physician Quality Reporting Initiative (PQRI)
  • Requires both NPI and tax ID number
  • 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 (PQRI Wizard(aafp.pqriwizard.com) is one option)
  • Via qualified electronic health record product
  • EHR data reporting through a qualified Physician Quality Reporting data submission vendor

Qualified Registries

A list of CMS qualified registries(www.cms.gov) is available on the CMS web site.

Claims Reporting

For claims reporting: a Physician Quality Reporting System (PQRS) Toolkit(www.ama-assn.org) 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.