Registration Now Open for PQRS Administrative Claims-Based Reporting

The Physician Quality Reporting System (PQRS) is a Centers for Medicare and Medicaid Services (CMS) reporting program that uses a combination of incentive payments and payment adjustments to promote reporting of quality information by eligible professionals (EPs). Any provider who sees Medicare Part B patients is eligible for PQRS. If you are not familiar with the PQRS program or are unsure about whether this program applies to you, more information can be found in a previous Practice Fusion EHRBloggers blog post.

PQRS Incentive Payments & Penalties

In 2013, it is particularly important for providers to understand their options related to PQRS participation because their actions will determine the potential (1) bonus incentive payments as well as (2) future payment adjustment (“penalties”) to the provider’s Medicare reimbursements.

Avoiding the 2015 Payment Adjustment Using the Administrative Claims-Based Mechanism

Eligible professionals who have chosen not to meet the requirements for the PQRS payment incentive in 2013, and do not want to report G-codes on Medicare claims to avoid the payment adjustment via that mechanism, should register for the administrative claims-based reporting mechanism before October 15, 2013.

Providers who choose the administrative claims-based reporting mechanism in 2013 to avoid the 2015 PQRS payment adjustment will be evaluated on 19 quality measures for 100% of their applicable Medicare Part B Fee-for-service beneficiaries to whom the measure applies.

To register for the CMS Administrative Claims Based Reporting Option for PQRS before October 15, 2013, follow the steps below:

  1. Register for an Individuals Authorized Access to the CMS Computer Services (CMS-IACS) account if you do not already have one, or add the appropriate IACS role if you already have an existing account. Registration for IACS is available at https://applications.cms.hhs.gov/ .
  2. Go to https://portal.cms.gov/  and select the PV PQRS option, near the bottom of the page to register. For additional information, please go to http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeedbackProgram/Self-Nomination-Registration.html

For assistance with the IACS sign up process or PQRS Reporting Option selection, please contact the CMS QualityNet Help Desk:

Monday – Friday: 8:00am – 8:00pm EST

Phone: (866) 288-8912 (TTY 1-877-715-6222)

Fax: (888) 329-7377

Email: qnetsupport@sdps.org

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  • John Bigboote

    What would really help here would be for Practice Fusion to support this by passing the CPT reporting codes to the billing program. Currently this involves using a paper cheat sheet to look up 5 different codes for each relevant Medicare patient and then entering them manually into the billing program. For Kareo, this is 10 clicks per code, so 50 clicks and the manual entry of 5 x 5 digit codes for every Medicare diabetic I see.

  • Deborah King

    I am a mental health professional, doing my own billing, buried in paperwork with constant insurance difficulties. Reviewing the process for this program makes me feel even more overwhelmed, most of my peers won’t even except insurance, let alone Medicare, and now I question it myself. Can you tell me what is involved in the 19 measure quality measure process that those of us who choose the ‘opt out’ administrative option subject ourselves to? Thank you.