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.
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:
- 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/ .
- 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