CMS Physician Quality Reporting System (PQRS)

PQRS and Your Practice

Physician Quality Reporting System 

  • Pay-for-reporting, not pay-for-performance
  • Multiple ways to participate/report
  • Registry participation is the most promising path for small- and medium-sized practices
  • PQRS is not a substitute for local quality improvement efforts
  • Penalties began in 2015 and will continue through 2018 for those who did not successfully report two years earlier (e.g. -2.0% in 2017 and 2018 if no successful reporting in 2015 and 2016, respectively).
  • PQRS outcomes are partially used to calculate the value-based payment modifier
  • In 2019 and beyond, PQRS will be replaced by the merit-based incentive payment system (MIPS)

PQRS Reporting Options

Individual eligible professionals (EPs) may report information on individual PQRS quality measures or group measures using the following mechanisms: 

  • Medicare Part B claims-based reporting (CPT II or G codes)
  • CMS-approved registry (PQRSwizard(aafp.pqrswizard.com) is one option)
  • Certified electronic health record technology (CEHRT) product
  • CEHRT via data submission vendor
  • Qualified clinical data registry (QCDR)

Group practices should register to report as a group. EPs within a group must report as individuals if the practice did not register. Group practices may report PQRS quality measures using the following mechanisms: 

  • CMS-approved registry (PQRSwizard(aafp.pqrswizard.com) is one option)
  • Web interface (for groups of 25+ EPs only)
  • Certified electronic health record technology (CEHRT) product
  • CEHRT via data submission vendor
  • Consumer Assessment of Healthcare Providers and Systems (CAHPS) for PQRS via CMS-certified survey vendor (for group practices of 2+ EPs) to supplement PQRS group practice reporting

Qualified Registries

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

The American Medical Association also maintains an inventory of national clinical registries(www.ama-assn.org).

AAFP PQRSwizard

PQRSwizard is a simple and cost-effective tool that makes reporting quality measures data under the CMS PQRS program easy.

Discount available for AAFP members.