PQRS

2012 Physician Quality Reporting System (PQRS)

From the CMS website: “Eligible Professionals who successfully report quality-measures data during the reporting period are eligible to earn an incentive payment equal to a percentage of the ep’s estimated total allowed charges for covered Medicare Part B Physician Fee Schedule (PFS) services provided during the reporting period.”

The Affordable Care Act authorized incentive payment through 2014;

• 2011 Physician Quality Reporting System-1%
• 2012 Physician Quality Reporting System-0.5%
• 2013 Physician Quality Reporting System-0.5%
• 2014 Physician Quality Reporting System-0.5%

Getting Started

STEP 1 -  Are you eligible to participate? You can download a list of professionals who are eligible and able to participate in PQRS here: https://www.cms.gov/PQRS/Downloads/EligibleProfessionals.pdf.  Carefully read through this list carefully to determine eligibility.

STEP 2 – Which PQRS reporting option(s) best fits your practice? claims-based or registry-based reporting of either individual measures or measures groups?

Also, which PQRS reporting period (12 months or 6 months where applicable) should I choose?  (this varies with the reporting option selected)

Refer to Appendix C and the PQRS Participation Decision Tree: 2012 Physician Quality Reporting Implementation Guide

STEP 3 – Read over the 2012 Physician Quality Reporting System Measures List to determine which Physician Quality Reporting System measures apply.

• 2012 Physician Quality Reporting System individual measures – select at least three applicable measures to submit to attempt to qualify for a Physician Quality Reporting System incentive payment.
• 2012 Physician Quality Reporting System measures groups – select at least one measures group to submit to attempt to qualify for a Physician Quality Reporting System incentive payment.

**Already participated in PQRS previously?

• no requirement to select new/different measures for the 2012 Physician Quality Reporting System

• still need to review the Physician Quality Reporting System measure specifications for 2012

STEP 4 – Time to review some documents:

Individual Physician Quality Reporting Measures

Once you have selected your 3 measures review the following documents:

• 2012 Physician Quality Reporting System Measure Specifications Manual for Claims and Registry – available at https://www.cms.gov/PQRS/03_How_To_Get_Started.asp#TopOfPage in the ‘Downloads’ section (print the pages of the measures you selected as this document is rather long)

• 2012 PQRS Implementation Guide

Or: As an alternative to reporting three individual measures, you can select to report one or more measures groups.

Physician Quality Reporting System Measures Groups

Once you have selected a measure group review the following documents:

• 2012 Physician Quality Reporting Measures Groups Specifications Manual and Release Notes and Getting Started with 2012 Physician Quality Reporting of Measures Groups (both available at https://www.cms.gov/PQRS/03_How_To_Get_Started.asp#TopOfPage in the ‘Downloads’ section)

Need Assistance??

QualityNet Help Desk

7:00 AM – 7:00 PM CT

Phone: 1-866-288-8912

TTY: 1-877-715-6222

Email: qnetsupport@sdps.org

AVAILABLE RESOURCES

The Physician Quality Reporting System and Electronic Eprescribing Quick-Reference Support Guide

Physician Quality Reporting Systems FAQs

Physician Quality Reporting Systems: Analysis and Payment

Login to our website (www.medisysinc.com) and click on EHR Resources at the top to download material/guides for PQRS.