Physician Quality Reporting System
Note: 2016 was the last program year for PQRS. PQRS transitioned to the Merit-based Incentive Payment System (MIPS) under the Quality Payment Program. The final data submission timeframe for reporting 2016 PQRS quality data to avoid the 2018 PQRS downward payment adjustment was January through March 2017. The first MIPS performance period was January through December 2017. For more information, please visit the Quality Payment Program website.
For transition and timeline information for both programs as PQRS activities decrease and CMS moves into MIPS, please view the Transitioning from the Physician Quality Reporting System (PQRS) to the Merit-based Incentive Payment System (MIPS) Resource Document. This helpful infographic includes key activities and corresponding dates for 2017 to 2019 for both MIPS and 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 downward 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 downward payment adjustment.
Please note that the CMS PQRS website and related CMS communications channels are the authoritative sources of accurate, up-to-date program information. New or updated information and educational materials regarding the PQRS program are announced widely to the provider community and posted on the PQRS Spotlight webpage.
PQRS Quick Links
- For information on payments, visit the Analysis and Payment webpage. Note that incentive payments were only authorized through 2014 program year reporting.
- For information on downward payment adjustments, review the Payment Adjustment Information webpage
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
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.
- Page last Modified: 04/26/2018 2:10 PM
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