Spotlight

2013 Quality Reporting Programs Matrix (04-02-2013)

This matrix provides practical summaries of three quality reporting programs—the Value Modifier, Physician Quality Reporting System (PQRS), and the Electronic Prescribing (eRx) Incentive Program—that affect payments to physicians and other eligible professionals.  To view click on the document titled "2013 Quality Reporting Programs Matrix" in the "Downloads" section on the "Educational Resources" page at left.

2011 Physician Quality Reporting System (PQRS) and Electronic Prescribing (eRx) Incentive Program Experience Report (03-29-2013)

• CMS has posted the 2011 Physician Quality Reporting System (PQRS) and Electronic Prescribing (eRx) Incentive Program Experience Report on the PQRS Overview section page. This report summarizes the reporting experience of eligible professionals in these programs in 2011, historical trends, and preliminary results for the 2012 program year. To view this document click on the link titled “2011 PQRS and ERx Experience Report” at left in the “Downloads” section.

*IMPORTANT UPDATE! The "2013 PQRS Measure Groups Specifications, Release Notes, Getting Started with 2013 PQRS Measures Groups, 2013 Quality-Data Code Categories, and 2013 PQRS Measures Groups Single Source Code Master" ZIP file located in the "Related Links" section on the "Measure Codes" page at left has a broken link.  Until this error has been corrected  go to the "Downloads" section on the "Measure Codes" page to view the below documents:  

• 2013 Physician Quality Reporting System (PQRS) Measures Groups Specifications Manual.  Measures group specifications are different from those of the individual measures that form the group. Therefore, the specifications and instructions for measures group reporting are provided in a separate manual. The 2013 measures groups specifications include codes and reporting instructions for the 22 PQRS measures groups for claims or registry-based reporting.

• 2013 Physician Quality Reporting System (PQRS) Measures Groups Release Notes.  This document outlines 2013 updates made to the 2012 PQRS Measures Groups Specifications Manual in the form of release notes.

•2013 Physician Quality Reporting System (PQRS) Getting Started with Measures Groups. This document provides guidance about how to select measures groups for reporting, and how to read and understand a measure group specification in order to satisfactorily report.

• 2013 Physician Quality Reporting System (PQRS) Quality-Data Code (QDC) Categories. A table that outlines, for each measure, each QDC that should be reported for a corresponding quality action performed by the individual eligible professional as noted in the measures specification. This identifies how each code will be used when calculating performance rates. This also clarifies those measures that require two or more QDCs to report satisfactorily. Insufficiently reporting the QDCs (as specified in the 2013 PQRS) will result as invalid reporting. NOTE: Measures groups specifications may differ from their individual measures counterpart. This document will define the differences between the QDCs for individual and measure group specifications.

• 2013 Physician Quality Reporting System (PQRS) Measures Groups Single Source Code Master. This file includes a numerical listing of all codes included in 2013 PQRS Measures Groups for incorporation into billing software.

Updated! The Comment Period Ends on April 8, 2013 for the Request for Information -- CMS-3276-NC (Announcement Posted on 02-07-2013, Updated on 03-13-2013)

CMS has published a request for information that solicits ways in which an eligible professional (EP) might use the clinical quality measures (CQM) data reported to specialty boards, specialty societies, regional health care quality organizations or other non-federal reporting programs to also report under the Physician Quality Reporting System (PQRS), as well as the Electronic Health Record (EHR) Incentive Program. It also solicits ways by which the entities already collecting CQM data for other reporting programs to submit this data on behalf of EPs and group practices for reporting under the PQRS and the EHR Incentive Program. It also requests information regarding section 601(b) of the American Taxpayer Relief Act of 2012 which provides for treating an EP as satisfactorily reporting data on quality measures if the EP is satisfactorily participating in a qualified clinical data registry.  The deadline to receive comments is April 8, 2013.  To view click on the link entitled "Request for Information--CMS-3276-NC" in the "Related Links" section on the "Statute Regulation Program" page at left. 

Updated!  2013 PQRS Measures Groups Specifications Release Notes (03-08-2013)

The 2013 PQRS Measures Groups Specifications Release Notes document was updated to indicate the removal of CPT codes from the IBD Measures Group and clarification for the Cardiovascular Prevention Measures Group. This document is posted on the PQRS "Measures Codes" section page.

Updated!  2013 PQRS MAV and Release Notes (03-08-2013)

The 2013 PQRS MAV and Release Notes documents were updated to include Measure #195.  This document is posted on the PQRS "Analysis and Payment" section page at left.  

Tips for Using the Quality Reporting Communication Support Page (03-05-2013)

A document titled "Tips for Using the Quality Reporting Communication Support Page" has been posted in the "Downloads" section on the "Educational Resources" and "Payment Adjustment Information" page at left.  This document provides tips for entering an eRx Hardship Exemption Request to avoid the 2014 eRx Payment Adjustment, a PQRS/eRx Feedback Report Request, a PQRS Informal Review Request and a Self-Nomination Request.  Please note self-nomination only applies to certain entities, including Maintenance of Certification Boards, Registries, EHR vendors and group practices wishing to participating in the Group Practice Reporting Option (GPRO).

March 19, 2013 National Provider Call with Question & Answer Session on the Physician Quality Reporting System and Electronic Prescribing (eRx) Incentive Program; 1:30 - 3:00pm ET. (02-25-2013)

The Centers for Medicare & Medicaid Services' (CMS) Provider Communications Group will be hosting a national provider conference call on the Physician Quality Reporting System and Electronic Prescribing (eRx) Incentive Program. This toll-free call will take place from 1:30 p.m. – 3:00 p.m., ET, on Tuesday, March 19, 2013.  

This National Provider Call provides an overview of how to report for PQRS and eRx through claims, including how to start reporting, key points, scenarios, and tips for satisfactorily reporting. The presentation also includes information about the claims-reporting process, 2013 reporting periods and frequency, coding/measure specification, review of CMS-1500 form, and other helpful hints. A Question & Answer session follows the presentation.  

Registration: The direct link to the registration page is http://www.eventsvc.com/blhtechnologies.  

The presentation materials have been posted in the "Downloads" section on the "CMS Sponsored Calls" page at left.  

2013 Participating Registry Vendors (02-25-2013)

The "2013 Participating Registry Vendors" document has been posted on the PQRS and eRx Incentive Program websites.  To view click on the document titled "2013 Participating Registry Vendors" in the "Downloads" section on the "Registry Reporting" page at left. 

2013 Qualified Data Submission Vendors (02-25-2013)

The PQRS and eRx Incentive Program "2013Qualified EHR Data Submission Vendors" document has been posted to this website.  To view click on the document titled “2013 Qualified Data Submission Vendors” in the “Downloads” section on the "Electronic Health Record Reporting" page at left.