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Physician Quality Reporting System

About PQRS

The Physician Quality Reporting System (PQRS) is a quality reporting program that encourages individual eligible professionals (EPs) and group practices to report information on the quality of care to Medicare. PQRS gives participating EPs and group practices the opportunity to assess the quality of care they provide to their patients, helping to ensure that patients get the right care at the right time. Click here for a brief introductory video that explains how PQRS can help improve health care and to whom the system applies.

By reporting on PQRS quality measures, individual EPs and group practices can also quantify how often they are meeting a particular quality metric. In 2015, the program began applying a negative payment adjustment to individual EPs and PQRS group practices who did not satisfactorily report data on quality measures for Medicare Part B Physician Fee Schedule (PFS) covered professional services in 2013. 

Those who report satisfactorily for the 2016 program year will avoid the 2018 PQRS negative payment adjustment.

Stay up to date on the latest PQRS news and updates by following us on Twitter and by subscribing to the PQRS Listserv.

PQRS Quick Links

For step-by step instructions on how to implement PQRS, view the How to Get Started webpage. In addition, learn more about PQRS and how to participate by visiting the following webpages:

Help Desk

If you have questions or need assistance with PQRS reporting, contact the QualityNet Help Desk. The Help Desk is available Monday – Friday; 7:00 AM – 7:00 PM Central Time (CT):
Phone: 1-866-288-8912 TTY: 1-877-715-6222 Email: Qnetsupport@hcqis.org

Sign-Up and Registration Information

While individual EPs do not need to sign up or pre-register in order to participate in PQRS, group practices wishing to participate via the GPRO must register. To avoid the PQRS negative payment adjustment, an EP or PQRS group practice must meet the criteria for satisfactory reporting specified by CMS for a particular reporting period. Please review the "2016 List of Eligible Professionals" on the PQRS How to Get Started webpage to confirm eligibility to participate in PQRS.

Note: The PQRS program requirements and measure specifications for the current program year may be different from the PQRS program requirements and measure specifications from a prior year. Individual EPs and PQRS group practices are responsible for ensuring that they are using the PQRS documents for the correct program year.

2016 PQRS

Individual EPs may choose to report information on individual PQRS quality measures or measures groups using a variety of mechanisms. Please see the PQRS How to Get Started webpage for a list of resources and where to find additional information. 

Disclaimer

Disclaimer: If a group is reporting for PQRS through another Centers for Medicare & Medicaid Services (CMS) program (such as the Comprehensive Primary Care Initiative, Medicare Shared Savings Program, or Pioneer Accountable Care Organizations), please check the program’s requirements for information on how to report quality data to avoid the PQRS payment adjustment. Please note: Although CMS has attempted to align or adopt similar reporting requirements across programs, EPs should look to the respective quality program to ensure they satisfy the requirements for each program (such as PQRS, EHR Incentive Program, Value-based Payment Modifier (Value Modifier), etc.) in which they participate.