2010 Physician Quality Reporting Initiative (PQRI) Program Update

It is not too late to start participating in the 2010 Physician Quality Reporting Initiative (PQRI) and potentially qualify to receive incentive payments.  A new six month reporting period begins on July 1, 2010.

The 2010 Physician Quality Reporting Initiative (PQRI) has two reporting periods: 12-months (January 1-December 31, 2010) and 6-months (July 1-December 31, 2010). For 2010, eligible professionals (EPs) who satisfactorily report PQRI measures for the 6-month reporting period will become eligible to receive a PQRI incentive equal to 2.0% of their total Medicare Part B allowed charges for services performed during the reporting period.

If you have not participated in the PQRI program, you can begin by reporting PQRI data for July 1-December 31, 2010 using any of the following four options:

• Claims-based reporting of individual measures for 80% or more of applicable patients on at least 3 individual measures or on each measure if less than 3 measures apply
• Claims-based reporting of one measures group for 80% or more of applicable Medicare Part B FFS patients of each EP (with a minimum of 8 patients)
• Registry-based reporting of at least 3 individual PQRI measures for 80% or more of applicable Medicare Part B FFS patients of each EP
• Registry-based reporting of one measures group for 80% or more of applicable Medicare Part B FFS patients of each EP (with a minimum of 8 patients)

PQRI claims-based reporting involves the addition of quality-data codes (QDC) to claims submitted for services when billing Medicare Part B. EPs also have the option of using a qualified registry to assist in collecting PQRI measure data. The registry will submit this quality data directly to Medicare, eliminating the need for adding QDCs to the Medicare Part B claim.

Eligible professionals do not need to sign up or pre-register to participate in the 2010 PQRI.  Submission of QDCs for individual PQRI measures to CMS through a qualified registry or for a measures group through claims or a qualified registry will indicate intent to participate.

Although there is no requirement to register prior to submitting the data, there are some preparatory steps that EPs should take prior to undertaking PQRI reporting.  CMS has created many educational products that provide information about how to get started with PQRI reporting.  To access all available educational resources on PQRI please visit, http://www.cms.hhs.gov/PQRI/ on the CMS website.  Eligible professionals are encouraged to visit the PQRI webpage often for the latest information and downloads on PQRI.

Resources

• 2010 PQRI Implementation Guide at http://www.cms.gov/PQRI/Downloads/2010_PQRI_ImplementationGuide_02-10-2010_FINAL.pdf

• Qualified Registries for 2010 PQRI Reporting at

http://www.cms.gov/PQRI/20_AlternativeReportingMechanisms.asp#TopOfPage

This entry was posted on Wednesday, May 19th, 2010 at 11:55 am and is filed under MEDICARE UPDATES. You can follow any responses to this entry through the RSS 2.0 feed. Responses are currently closed, but you can trackback from your own site.