Medicare Physician Quality Reporting System | aad.org

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Medicare Physician Quality Reporting System

Get started with PQRS


Enroll now

Purchase the 2014 Quality Reporting System (QRS).

 

Returning participants' login

If you have already purchased a QRS module, log in here to report your measures.                

            

2014 Quality Reporting System (QRS) tutorial

An online tutorial that details QRS and what's new in 2014.              

Dermatology measures for 2014             

There are five dermatology-specific measures that providers can report on.

            

CMS PQRS Information           

Learn more about PQRS from the CMS website.

            

Frequently          asked questions

Download this document to get more in-depth answers about the AAD QRS and Medicare PQRS programs.

Quality reporting
for physician extenders

The AAD's 2014 QRS module is  open to Physician Assistants (PA), Nurse Practitioners (NP), Clinical Nurse Specialists (CNS), and Advanced Practice Registered Nurses (APRN) who are affiliated with AAD members.

            

QualityNet
Help Desk

Contact CMS' dedicated support for PQRS-related questions.

           

PQRS Experience Report

Download the full CMS PQRS Experience Report to see how physicians have performed in the past.

      

 

            

Model physician treatment plan letter for melanoma coordination of care measure

Communicate your treatment plan to a patient's primary care physician.

Frequently asked questions

The following are frequently asked questions about the Medicare Physician Quality Reporting System (PQRS). Reporting quality performance measures assists AAD members in improving patient safety and quality in their clinical practice settings. The best-practice measures are meant to encourage practices to align their clinical operations with the quality measures the AAD establishes and that are approved by both the National Quality Forum (NQF) and the Centers for Medicare and Medicaid Services (CMS).

Q: What is the Physician Quality Reporting System?
A: The Physician Quality Reporting System (PQRS), formerly known as PQRI, is a program developed by the Centers for Medicare and Medicaid Services (CMS) to provide a financial incentive bonus to physicians who report on best-practice quality measures for the Medicare patients they treat.

 

Q: If I participated in PQRS and did not earn an incentive, can I appeal to CMS?
A: CMS allows participants to request an informal appeal via the QualityNet Help Desk so your PQRS data can be reviewed to determine if a mistake was made. You can contact the QualityNet Help Desk at (866) 288-8912 (TTY (877) 715-6222) or at http://qnetsupport@sdps.org. They are available Monday through Friday from 7 a.m. to 7 p.m. CT.

 

Q: How will the health care reform law affect PQRS?
A: The Patient Protection and Affordable Care Act will continue to offer incentives for participation through 2014. However, also in 2014, an eligible professional will have to report on at least three measures, on at least 50 percent of patients that apply to each measure, to avoid a 2.0 percent payment reduction in 2016.


Q: How much will my incentive payment be?
A: If a participant successfully meets all criteria of the PQRS program, he or she will receive a bonus of 0.5 percent of total allowed Medicare Part B charges to CMS for the calendar year.

 

Q: Is there a penalty associated with PQRS?
A: Yes, if one does not report at least at least three measures, on at least 50 percent of patients that apply to each measure in 2014, then he or she will be assessed a 2.0 percent payment reduction in 2016.

 

Q: How many measures do I have to report to earn an incentive?
A: Providers must report a minimum of nine measures to earn the incentive. There is no advantage to reporting more than nine.

 

Q: How many measures do I have to meet if I am reporting to earn an incentive?
A: You do not have to meet every measure, however:

  • You must have greater than a 0 percent performance rate for all reported measures.
  • Not every reported patient needs to meet all nine measures.
  • Each of the chosen quality measures must have at least one eligible instance.

Q: How many measures do I have to report to avoid the 2.0 percent payment reduction in 2016?
A: The 2.0 percent payment reduction will occur in 2016, and will be based on your participation in 2014. To avoid this payment reduction, you have to report at least three measures, on at least 50 percent of patients who apply to each measure. This can be done either through a registry, or via claims (keep in mind that the dermatology-appropriate measures can only be reported via registry). Reporting three measures will only exempt you from the payment reduction; you still need to report nine measures to be eligible for the incentive.

Q: The dermatologist I work for told me I need to submit his or her PQRS information through a registry. What does that mean?
A: A registry is an electronic system that is built by an outside company (vendor) that allows practice staff to enter quality information online. All vendors have to be registered with CMS on a qualified list  to report PQRS data.

Q: I participated in this program in the past using my claims forms; am I able to do that this year?
A: Some PQRS measures may be reported via claims, however, if you choose to report the dermatology-appropriate measures #137, #138, #224, #265, #337, then you must report via a registry. CMS determined that these measures can only be answered through an electronic registry in 2014. However, there are other PQRS measures that you may be able to report via claims.


How have physicians performed in the past?

PQRS performance — All MD/DO participants and dermatology MD/DO participants

  Population
% earning incentive: claims
% earning incentive: registry
Mean incentive earned
Median incentive earned
 2009
(incentive amount: 2%)
 All MD/DO
 50.1  91.6  $2,274.42  $1,236.17
 Dermatology  34.0  93.4  $5,277.39  $3,347.23
 2010
(incentive amount: 2%)
 All MD/DO
 61.5  89.0  $2,519.87  $1,364.14
 Dermatology  59.1  91.1  $7,462.06  $4,910.12
 2011
(incentive amount: 1%)
 All MD/DO
 77.1  90.3  $1,259.14  $686.08
 Dermatology  67.7  94.8  $3,881.27  $2,543.14

 

PQRS performance  (all reporting methods) — Other specialties by comparison

Reporting
year
 
Specialty  Number
participating
Number
earning
incentive
Percent
earning
incentive
 
Mean
incentive
earned
 
Median
incentive
earned
 
2009
(incentive
amount: 2%)
 Dermatology  2,106  900  42.7%  $5,277.39  $3,347.23
 Rheumatology  1,156  682  59.0%  $3,104.01  $2,004.23
 Ophthalmology  7,387  3,695  50.0%  $7,266.00  $5,847.13
2010
(incentive
amount: 2%)
 Dermatology  1,725  1,451  84.1%  $7,462.06  $4,910.12
 Rheumatology  1,386  994  71.7%  $3,515.70  $2,640.73
 Ophthalmology  8,144  5,216  64.0%  $7,750.95  $6,182.11
2011
(incentive
amount: 1%)
 Dermatology  2,310  2,075  89.8%  $3,881.27  $2,543.14
 Rheumatology  1,530  1,177  76.9%  $1,673.40  $1,172.71
 Ophthalmology  8,828  7,011  79.4%  $3,797.63  $3,009.49
  

Source: U.S. Department of Health and Human Services. Centers for Medicare and Medicaid Services. 2011 reporting experience, including trends (2008-2012): Physician Quality Reporting System and electronic prescribing (eRx) incentive program. March 26, 2013.