As 2015 draws to a close, so does the 2015 Physician Quality Reporting System (PQRS) reporting year. Before the year is over, take some time to ensure you are successfully wrapping up your 2015 PQRS reporting. While successfully reporting PQRS will no longer earn you or your group an incentive payment, it will ensure that you avoid a 2 percent PQRS payment adjustment, as well as help you avoid the additional 1 to 2 percent payment adjustment levied under the Value-Based Payment Modifier.
Wrapping up 2015 PQRS
- If you have done nothing related to PQRS for the 2015 reporting year, your options are limited. You can no longer participate as a group in any of the GPRO reporting methods, and you do not have time to achieve a 50 percent reporting rate for claims reporting. It may still be possible to participate in PQRS for the 2015 calendar year as individual providers via the qualified registry, EHR, or qualified clinical data registrymethods. Follow the links for more details.
- If you are participating via the claims reporting option as an individual provider, continue to submit the quality data codes for your chosen measures through February 26, 2016, for 2015 dates of service.
- If you are participating as an individual provider or group via the qualified registry, EHR, or qualified clinical data registry options, get in touch with your vendors to confirm data submission guidelines.
- If you are participating in any of the GPRO options, make sure you have your staff and administrator access up-to-date for the physician value portlet at the CMS.gov Enterprise Portal.
Submission periods for 2015 PQRS are as follows:
- January 1, 2016: First day to submit 2015 PQRS data using registry, EHR, or QCDR
- January 18, 2016: 2015 GPRO Web Interface submission period begins
- February 26, 2016: Last day that 2015 claims will be processed to be counted for PQRS reporting to determine the 2017 payment adjustment
- February 29, 2016: Last day to submit 2015 CQMs for dual participation in PQRS and the Medicare EHR Incentive Program; Last day for QCDRs (QRDA) and EHRs to submit 2015 data
- March 15, 2016: 2015 GPRO Web Interface submission period ends
- March 31, 2016: Last day for QCDRs (QCDR XML only) and registries to submit 2015 data
As the Centers for Medicare and Medicaid Services begins to update their PQRS resources with specific guidelines and measures for the 2016 program year, CIPROMS will offer additional guidance for getting started with the new reporting year.
Remember, 2016 is the last reporting year for PQRS, and 2018 will be the last year for PQRS payment adjustments. Beginning with the 2017 reporting year (which will affect the 2019 payment year), physicians will be subject to the guidelines of the Merit-Based Incentive Payment System (MIPS), mandated through the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) back in April.
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