Frequently Asked Questions

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FAQ

Does the Physician Quality Reporting System (PQRS) 0% performance rule apply to reporting during the 2013 PQRS program year for purposes of avoiding the 2015 PQRS payment adjustment?

 

 

 

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The PQRS 0% performance rule only applies to satisfactory reporting for 2013 PQRS incentive eligibility. The 0% performance rate does not apply to the less stringent reporting criteria of reporting 1 valid measure or 1 valid measures group, or electing to participate in the administrative claims reporting mechanism, for purposes of avoiding the 2015 PQRS payment adjustment.

 

However, CMS strongly encourages all eligible professionals and group practices to become familiar with the PQRS requirements for satisfactorily reporting and meeting the 0% performance rule for incentive eligibility. CMS indicated in the 2013 PFS Final Rule that the less stringent reporting criteria (reporting 1 valid measure or 1 valid measures group, or electing to participate in the administrative claims-based reporting mechanism) may be temporary. Rulemaking will determine whether or not the less stringent reporting criteria will be available in future program years.

 

For information on the PQRS payment adjustment see the CMS PQRS website at http://cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Payment-Adjustment-Information.html

 

For additional information on the administrative claims-based reporting mechanism visit the CMS Value-based Payment Modifier website at http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeedbackProgram/ValueBasedPaymentModifier.html.

 


(FAQ8356)

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