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Educational Resources

The educational resources listed on this page are designed to increase awareness and knowledge of the Physician Quality Reporting System (PQRS). Individual eligible professionals (EPs) and group practices are encouraged to contact their professional organizations for additional information and tools that will facilitate participation in PQRS.

Many of the educational resource documents include icons indicating the intended audience (beginner, intermediate, advanced, and all levels).

Beginner 101: A beginner-level educational product is generally tailored for the participant who is new to CMS quality reporting and has limited knowledge or experience with PQRS. A beginner is typically in his or her first year of participation, so this product addresses more basic program information such as:

  • What is PQRS?
  • How does PQRS impact me?
  • How do I get started?
  • What is a quality measure?

Intermediate 201: An intermediate-level educational product is designed for the participant who has 1 to 3 years of PQRS program knowledge and experience, or has mastered the beginner-level material. This product addresses more complex program information, such as:

  • Different reporting mechanisms
  • What reporting mechanism is best for me and/or my group practice?
  • What does program alignment mean?
  • How do I/my group practice report once across multiple Medicare quality reporting programs?
  • What are the requirements behind the Measure-Applicability Validation test?

Advanced 301: An advanced-level educational product is constructed for the participant with extensive knowledge and experience in PQRS (typically 3+ years of participation or supporting complex processes related to the program), or has mastered the intermediate-level material. This product enhances a participant’s in-depth knowledge of the program with additional intricate information such as:

  • Changes to program policy and requirements
  • PQRS impacts to eligible professionals participating in other programs such as Medicare Shared Savings Program, Pioneer, and  Comprehensive Primary Care Initiative  
  • Complex data submission requirements such as the Quality Reporting Document Architecture (QRDA) Implementation Guide

All Levels: An all-levels educational product is constructed for the participant with any level of knowledge and experience in PQRS (from entirely new/beginner, to intermediate, and advanced), including those with vendor responsibilities. This product enhances a participant’s/supporter’s general knowledge of the program with additional helpful information such as:

  • A complete list and description of PQRS eligible professionals (EPs)
  • Criteria documents for entities interested in becoming a qualified registry, qualified clinical data registry (QCDR), or group practice registering to participate in PQRS through the group practice reporting option (GPRO)
  • List of qualified registries who can submit PQRS information on behalf of an eligible professional or group practice

2015 PQRS Resources

The following educational products are available to assist EPs and group practices with 2015 PQRS reporting and participation.

2015 Beginner Reporter Toolkit New to quality reporting or need a refresher? This beginner-level toolkit contains two documents to help individual EPs and PQRS group practices navigate their way through the various PQRS decision points and the impact of quality reporting. These two resources are meant to complement one another:

  • Learn how to report with the “Quality Reporting Roadmap.”
  • Learn how your data is utilized with the “Take a Moment & Participate Flowchart.”

2015 PQRS List of Eligible Professionals – Read this document carefully to determine whether or not you are eligible to participate in 2015 PQRS.

2015 PQRS Implementation Guide – This guide helps EPs and PQRS group practices of all awareness levels understand and report for 2015 PQRS. It includes PQRS information related to the program itself, measures and analysis, and reporting.

How to Report Once for 2015 Medicare Quality Reporting Programs – This intermediate-level document offers guidance on aligned reporting mechanisms for both individual EPs and group practices reporting across PQRS, Medicare EHR Incentive Program, Value Modifier, and Accountable Care Organizations in order to avoid the 2017 negative payment adjustment. Please note: this document only includes aligned options and does not contain all PQRS reporting options.

2015-2017 PQRS Timeline – Locate 2015-2017 milestone dates and corresponding resources in this PQRS timeline.  

2015 PQRS List of Face-to-Face Encounter Codes  – This is a list of billable codes that identify face-to-face encounters for the purposes of 2015 PQRS reporting.  

2015 Cross-Cutting Measures List – Lists broadly applicable 2015 PQRS measures that are defined as cross-cutting.

2015 Measure-Applicability Validation (MAV) Training Course – Course for EPs reporting measures via claims or an EP or PQRS group practice reporting measures via a registry vendor.

2015 PQRS Claims-Based Coding and Reporting Principles –  This beginner-level resource describes claims-based coding and reporting and outlines steps that EPs should take prior to participating in 2015 PQRS.

2015 Claims Reporting Made Simple – This beginner-level resource describes claims-based reporting and outlines steps that EPs should take prior to participating in 2015 PQRS.

2015 PQRS EHR Reporting Made Simple – This beginner-level document outlines reporting electronically using an EHR for 2015 PQRS. It applies to individual EPs who wish to report using an EHR and PQRS group practices that registered to report via the Group Practice Reporting Option (GPRO) using an EHR.

2015 GPRO EHR Reporting for Vendors – An intermediate-level fact sheet is now available on 2015 GPRO reporting using an EHR for EHR vendors. This includes information about how EHR Direct and Data Submission Vendors should report 2015 PQRS for group practices participating in PQRS GPRO.

2015 Guide for Group Practices Reporting via PQRS GPRO Using an EHR – This beginner-level fact sheet was developed to assist PQRS group practices participating in GPRO reporting using a direct EHR product or Data Submission Vendor.

2015 PQRS GPRO Criteria – This document outlines how to determine group size, criteria for participation through PQRS GPRO, registration information, and resources for additional information about the 2015 PQRS GPRO.

Understanding the 2015 Medicare Payment Adjustments – This guide provides a general overview of the 2015 payment adjustments for CMS Medicare quality reporting.

CAH-II Reporting for PQRS - CMS has packaged several documents containing information that is relevant to Critical Access Hospitals (CAHs) billing under Method II in relation to 2014 and 2015 PQRS.

2015 PQRS Participation and Payment Adjustment for Providers Who Rendered Services at Independent Diagnostic Testing Facilities (IDTFs) and Independent Labs (ILs) – CMS has updated information for EPs rendering services at IDTFs and ILs. Please see this document for details.

2015 PQRS Qualified Registry Training Guide - An intermediary-level resource that provides information to EPs (individuals and group practices participating via GPRO) and qualified registry vendors about reporting 2015 PQRS via qualified registry, the benefits of participating via a qualified registry, information about the Submission Engine Validation Tool (SEVT), information about production submission, and lessons learned from previous program years.

2015 PQRS GPRO Training Guide - An intermediary-level resource that provides information to eligible professionals about the requirements and options for participating in PQRS through the GPRO for the 2015 program year. It includes tips on choosing the GPRO reporting mechanism that best fits your group practice and an overview of the Physician Compare website.

2014-2016 PQRS Resources

PQRS Timeline 2014-2016 – Includes important PQRS dates from 2014-2016, as well as corresponding resources for each PQRS milestone.

2014 PQRS: 2016 PQRS Payment Adjustment – This fact sheet provides information on the 2016 PQRS payment adjustment and guidance on how individual EPs and group practices can avoid the 2016 PQRS payment adjustment. Information provided in this fact sheet is based on the 2014 Medicare Physician Fee Schedule (MPFS) Final Rule.