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Group Practice Reporting Option

In accordance with section 1848(m)(3)(C) of the Social Security Act (the Act), CMS created a new group practice reporting option (GPRO) for the Physician Quality Reporting System (PQRS) in 2010. Group practices participating in GPRO that satisfactorily report data on PQRS measures for a particular reporting period are eligible to earn a PQRS incentive payment equal to a specified percentage of the group practice's total estimated Medicare Part B Physician Fee Schedule (PFS) allowed charges for covered professional services furnished during the reporting period. 

To earn an incentive for the 2014 PQRS program year, group practices participating in GPRO may register to participate in GPRO via:

(1) Qualified PQRS registry
(2) Web interface (for groups of 25+ only)
(3) Direct electronic health record (EHR) using certified EHR technology (CEHRT)
(4) CERHT via Data Submission Vendor
(5) CAHPS via CMS-certified survey vendor (for groups of 25+ only)

2014 PQRS GPRO Requirements

The PQRS GPRO 2014 Requirements document outlines the criteria for participating in 2014 PQRS through the GPRO. The document outlines how to determine group size, criteria for participation through the GPRO, registration information, and resources for additional information about the 2014 PQRS GPRO. To view click on the following link: 2014 PQRS GPRO Requirements document.

More information about participating in GPRO via registry or Web Interface is detailed below.

2014 PQRS GPRO Measures Using the Registry Reporting Method

Group practices participating in 2014 PQRS GPRO reporting via registry will be required to submit nine or more individual PQRS measures on at least 50% of the group’s applicable Medicare Part B FFS patients. If fewer than nine measures or if less than three NQS domains are reported via a qualified registry, CMS will apply a measure-applicability validation (MAV) process when determining incentive eligibility. Refer to MAV information available on the Analysis and Payment page.  

The “2014 Physician Quality Reporting System (PQRS) Claims/Registry Measures Specifications Manual” is to be used for this method of reporting and can be found on the Measures Codes page of the CMS PQRS website. The 2014 measures specifications include codes and reporting instructions for PQRS claims and registry-based reporting. A list of measures available for registry reporting can be found in the “2014 Physician Quality Reporting System (PQRS) Measures List” on the Measures Codes page of the CMS PQRS website.

To select a registry vendor, refer to the “2014 Participating Registry Vendors” list on the Registry Reporting page of the CMS PQRS website.

2014 PQRS GPRO Measures Using the Web Interface Reporting Method

For purposes of determining whether a group practice participating in GPRO satisfactorily submits PQRS quality measures data for 2014, each group practice participating in the 2014 PQRS Web Interface GPRO reporting method will be required to report 17 quality measures (22 individual measures when accounting for the two composite measures).

A description of each of the 22 measures can be found in the 2014 Group Practice Reporting Option (GPRO) Web Interface Narrative Measure Specifications and the updates made to the measures from 2013 can be found in the 2014 GPRO Web Interface Measures List, Narrative Measure Specifications, and Release Notes zip file.

2014 GPRO EHR Reporting for Group Practices

CMS has posted a fact sheet about 2014 GPRO EHR-based reporting for group practices, which was developed to assist group practices participating in GPRO reporting through EHR Direct or Data Submission Vendors. Group practices participating in GPRO through EHR reporting should review this document by clicking on the following link: 2014 GPRO EHR Reporting for Groups.

Group practices participating in 2014 GPRO via EHR reporting will need to work directly with their EHR Direct or Data Submission Vendor.

2014 GPRO EHR Reporting for Vendors

CMS has posted a fact sheet about 2014 GPRO EHR-based reporting for EHR vendors, which includes information about how EHR Direct and Data Submission Vendors should report 2014 PQRS for group practices participating in PQRS GPRO. EHR Vendors wishing to participate in the 2014 PQRS and submit data for groups participating in PQRS GPRO should review this document by clicking on the following link: 2014 GPRO EHR Reporting for Vendors.

Group practices participating in 2014 GPRO via EHR reporting will need to work directly with their EHR Direct or Data Submission Vendor.

2014 PQRS GPRO Trainings

The following presentations provide training about the requirements and options for participating in PQRS through the GPRO for the 2014 program year.  

2014 PQRS GPRO – 101 / Introduction
2014 PQRS and ACO GPRO – Public Reporting
2014 PQRS GPRO – Value-based Payment Modifier (VM)
2014 PQRS GPRO – Which Reporting Method is Right for My Group?

Please note that additional presentations will be added as they become available.

Disclaimer

If reporting for PQRS through another CMS program (such as the Medicare Shared Savings Program, Comprehensive Primary Care Initiative, Pioneer Accountable Care Organizations), please check the program’s requirements for information on how to report quality data to earn a PQRS incentive and/or avoid the PQRS payment adjustment.  Please note, although CMS has attempted to align or adopt similar reporting requirements across programs, eligible professionals should look to the respective quality program to ensure they satisfy the PQRS, EHR Incentive Program, Value-Based Payment Modifier (VBM), etc. requirements of each of these programs.