Electronic Health Record Reporting

Electronic Health Record (EHR) Reporting

Beginning with the 2010 Physician Quality Reporting System (PQRS) program year, eligible professionals may qualify to earn a PQRS incentive through the EHR-based reporting method.  Eligible professionals have the following EHR-based reporting options:

1) Submit PQRS quality measure data directly from their EHR system.  Eligible professionals who choose to report on EHR measures must report on a minimum of three measures for Medicare Part B beneficiaries at an 80 percent reporting rate to be able to qualify to earn a PQRS incentive payment.  Please refer to the relevant program year EHR Documents for Eligible Professionals zip file for a list of measures available for reporting.  Eligible professionals participating in PQRS utilizing a qualified EHR Direct product should contact the qualified EHR Direct Vendor for additional details on submission.

2) Submit PQRS quality measure data extracted from their EHR to a qualified EHR Data Submission Vendor. The EHR Data Submission Vendor would then submit the PQRS measures data to CMS in the CMS-specified format(s) on the eligible professional’s behalf.  Eligible professionals who choose to report on EHR measures must report on a minimum of three measures for Medicare Part B beneficiaries at an 80 percent reporting rate to be able to qualify to earn a PQRS incentive payment.  Please refer to the relevant program year EHR Documents for Eligible Professionals zip file for a list of measures available for reporting.  Eligible professionals participating in PQRS utilizing a qualified EHR Data Submission Vendor should contact the qualified EHR Data Submission Vendor for additional details on submission.

3) Submit quality measure data through the PQRS-Medicare EHR Incentive Program Pilot which uses specific 2012 Physician Quality Reporting EHR measure specifications.  Eligible professionals participating in the Pilot are required to submit information on three core measures. If the denominator for one or more of the core measures is zero, the eligible professional must report on up to three alternate core measures. Eligible professionals must also report on three additional measures available for the Medicare EHR Incentive Program. Please refer to the 2012 Physician Quality Reporting System-Medicare EHR Incentive Pilot Quick-Reference Guide for a list of the core, alternate core and additional measures available for reporting.

2013 Physician Quality Reporting System

2013 Qualified EHR Data Submission Vendors

CMS is pleased to announce the 2013 EHR Data Submission Vendors that self-nominated to submit quality data to CMS for the 2013 Physician Quality Reporting System program year. Each of these EHR Data Submission Vendors will complete a thorough vetting process to verify they have the capability to provide the required data elements for the measures they intend to submit. An updated list of vendors will be posted once the vetting has been completed. See the list of participating Registry Vendors and additional information within the document titled “2013 Qualified Data Submission Vendors” in the “Downloads” section below.

2013 Physician Quality Reporting System (PQRS) Medicare Electronic Health Record (EHR) Incentive Pilot: Quick-Reference Guide

2013 Physician Quality Reporting System Medicare Electronic Health Record (EHR) Incentive Pilot: Quick Reference Guide.  This Quick-Reference Guide provides direction to eligible professionals participating in the Medicare EHR Incentive Program on reporting and satisfying the CQM requirements through participation in the PQRS-Medicare EHR Incentive Pilot. To view click on link titled "2013 Physician Quality Reporting System (PQRS) Medicare Electronic Health Record (EHR) Incentive Pilot: Quick-Reference Guide" in the "Download" section below.

2013 Physician Quality Reporting System (PQRS): Electronic Health Record (EHR) Reporting Made Simple. 

This document describes EHR-based reporting and outlines steps that eligible professionals should take in selecting an EHR to work with for the 2013 program year.

2013 EHR Data Submission Vendor Criteria

CMS has posted the criteria for 2013 EHR Data Submission Vendors, which includes information regarding the self-nomination process. EHR Data Submission Vendors wishing to participate in the 2013 Physician Quality Reporting System should review the document entitled "2013 EHR Data Submission Vendor Criteria" in the "Downloads" section below.

2013 EHR Direct Vendor Qualified Posting

CMS is pleased to announce the 2013 Physician Quality Reporting System EHR Direct vendors and their systems (including specific version or release). These systems have been “qualified” to submit quality data to CMS by eligible professionals for the 2013 PQRS program year. Each of these EHR Direct vendors completed a thorough vetting process to verify that their system has the capability to provide the required data elements for the 51 PQRS EHR measures.  See the list of qualified vendors and additional information within the document titled “2013 EHR Direct Vendor Qualified Posting” in the “Downloads” section below.

Documents for 2013 EHR-Based Reporting

CMS will accept PQRS quality measures data extracted from a qualified EHR product for a limited subset of 2013 PQRS quality measures. As stated in the 2013 PFS final rule, 51 measures are available for EHR-based reporting in 2013. The following documents for the electronic submission of these 51 measures  by eligible professionals using a "qualified" EHR are available in two ZIP files in the "Related Links" section below.  

2013 EHR Direct Qualification Criteria for the 2013 Physician Quality Reporting System

The self-nomination and vetting process for EHR vendors for 2013 Physician Quality Reporting has been posted. This document describes the Qualifications for self-nomination including important deadlines. More information is available in the "Downloads" section below.

Final Documents for 2013 EHR-Based Reporting

• 2013 EHR Documents for Eligible Professionals ZIP file containing:

- 2013 Physician Quality Reporting System (PQRS) EHR Measure Specifications – The detailed description of data element names and codes related to each of 51 2013 Physician Quality Reporting System quality measures available for electronic submission.

- 2013 Physician Quality Reporting System (PQRS) EHR Measure Specifications – Release Notes – The corresponding release notes for the 2013 EHR Measure Specifications.

- 2013 EHR Downloadable Resource Table

- 2013 EHR Downloadable Resource Table – Release Notes

• 2013  EHR Documents for Vendors ZIP file containing the 2013 EHR Data Submission Specifications and Release Notes v4.1. 

- 2013 CMS EHR QRDA Data Submission Specifications v4.1 

- 2013 CMS EHR QRDA Body Error Edits dated 07112012 

- 2013 CMS EHR QRDA Header Error Edits dated 04202012 

- 2013 CMS EHR QRDA Data Submission Error Edits Release Notes v4.1 

- 2013 EHR Downloadable Resource Table v4.1 

- 2013 EHR Downloadable Resource Table-Other Resource Codes dated Mar 2012 

- 2013 EHR Downloadable Resource Table Release Notes v4.1 

2012 Physician Quality Reporting System

2012 Data Submission Vendor XML File Specification EHR Aggregate

The Data Submission Vendor XML File Specification EHR Aggregate for program year 2012 has been posted to this section page.  To view click on document titled "2012 Data Submission Vendor XML File Specification EHR Aggregate" in the "Downloads" section below.
2012 Phase 1 EHR Direct Qualified Posting

CMS is pleased to announce EHR Direct vendors and their system and products (including specific version or release) that have been "qualified" to submit quality data to CMS by eligible professionals for the 2012 Physician Quality Reporting System program year. Each of these EHR Direct vendors has completed a thorough vetting process to verify that their system and product(s) has the capability to provide the required data elements for the 51 Physician Quality Reporting System EHR measures. Some EHR Direct vendors are also capable of reporting the electronic prescribing (eRx) measure to CMS.The 2012 PFS Final Rule has extended the vetting period for additional EHR Direct Vendors to become qualified for the 2012 program year. An updated Qualified Posting will be posted once testing on these new entities has been completed. See the table and more information in the document titled "2012 Phase 1 EHR Direct Qualified Posting" in the "Downloads" section below.

2012 Physician Quality Reporting System Medicare Electronic Health Record (EHR) Incentive Pilot: Quick Reference Guide. This Quick-Reference Guide provides direction to eligible professionals participating in the Medicare EHR Incentive Program on reporting and satisfying the CQM requirements through participation in the Physician Quality Reporting System-Medicare EHR Incentive Pilot. More information is available in the "Downloads" section below.

2012 EHR Direct Vendor Qualification Requirements for the 2012 Physician Quality Reporting Program Year

The self-nomination and vetting process for EHR vendors for 2012 Physician Quality Reporting has been updated. This document describes the requirements for self-nomination including important deadlines for qualification. More information is available in the "Downloads" section below.

2012 EHR Data Submission Vendor Qualification Requirements for the 2012 Physician Quality Reporting Program Year

The self-nomination and vetting process for EHR Data Submission vendors for 2012 Physician Quality Reporting will occur in 2012. This document describes the requirements for self-nomination including important deadlines for qualification. More information is available in the "Downloads" section below.

Final Documents for 2012 EHR-Based Reporting

CMS will again accept Physician Quality Reporting System quality measures data extracted from a qualified EHR product for a limited subset of proposed 2012 Physician Quality Reporting System quality measures. As stated in the 2012 PFS final rule, 51 measures are available for EHR-based reporting in 2012. The following documents for the electronic submission of these 51 measures by eligible professionals using a "qualified" EHR is available in two ZIP files in the "Related Links" section below:

• 2012 EHR Documents for Eligible Professionals ZIP file containing:

- 2012 Physician Quality Reporting System EHR Measure Specifications - The detailed description of data element names and codes related to each of 51 2012 Physician Quality Reporting System quality measures available for electronic submission.

- 2012 Physician Quality Reporting System EHR Measure Specifications – Release Notes – The corresponding release notes for the 2012 EHR Measure Specifications.

- 2012 EHR Downloadable Resource Table

- 2012 EHR Downloadable Resource Table - Release Notes

• 2012 EHR Documents for Vendors ZIP file containing:

- Data Submission Specifications Utilizing HL7 QRDA Implementation Guide Based on HL7 CDA Release 3.0

- Updated EHR Data Submission Specifications Utilizing QRDA – Release Notes – Release notes for Data Submission Specifications Utilizing HL7 Quality Reporting Document Architecture Based on HL7 CDA Release 2.0

- 2012 EHR Downloadable Resource Tables - (2012 EHR Downloadable Resource Table and 2012 EHR Downloadable Resource Table – Other Resource Codes)

- 2012 EHR Downloadable Resource Table - Release Notes

- 2012 EHR Data Submission Specifications Utilizing QRDA Header Errors and Edits

- 2012 EHR Data Submission Specifications Utilizing QRDA Body Errors and Edits

EHR Vendor Qualification Requirements for the 2012 Physician Quality Reporting Program Year

The self-nomination and vetting process for EHR vendors for 2012 Physician Quality Reporting will occur in 2011. This document describes the requirements for self-nomination including important deadlines for qualification. More information is available in the "Downloads" section below.

2012 Physician Quality Reporting  Decision Tree.  This document contains a decision tree flow chart for 2012 reporting options.  This document is available in the "Downloads" section below.

NOTE: Previous Physician Quality Reporting System Program Year Documents

All previous program year documents will be moved to the appropriate program year section page at left.