What is PQRS?
The Physician Quality Reporting System (PQRS) is a voluntary quality reporting program that uses a combination of incentive payments and payment adjustments (penalties) to promote reporting of quality measures.
Learn more about PQRS here.
Learn more about PQRS Reporting here.
How do I know if I should be reporting for PQRS?
Physicians and other eligible professionals (EPs) who provide covered Physician Fee Schedule (PFS) services to Medicare Part B Fee-for-Service (FFS) beneficiaries (including Railroad Retirement Board and Medicare Secondary Payer) are eligible to report on PQRS.
You can determine your eligibility for PQRS and other quality reporting programs via CMS’s website here.
What is a QCDR?
Established under the 2014 Medicare Physician Fee Schedule Final Rule, a Qualified Clinical Data Registry (QCDR) is defined as a CMS-approved entity (such as a registry, certification board, collaborative, etc.) that collects medical and/or clinical data for the purpose of patient and disease tracking to foster improvement in the quality of care furnished to patients.
The Qualified Clinical Data Registry reporting option is different from a traditional registry because it is not limited to measures within PQRS. The QCDR can host “non-PQRS” measures approved by CMS for reporting.
What are the National Quality Strategy Domains?
All measures in the PQRS fall into one of six domains which represent the Department of Health and Human Services’ National Quality Strategy priorities for health care quality improvement.
The 6 domains are:
• Patient Safety
• Person and Caregiver-Centered Experience and Outcomes
• Communication and Care Coordination
• Effective Clinical Care
• Community/Population Health
• Efficiency and Cost Reduction
What measures are available for reporting through the AAAAI QCDR in 2015?
• PQRS Measure #53 (NQF 0047): Asthma: Pharmacologic Therapy for Persistent Asthma - Ambulatory Care Setting
• PQRS Measure #398: Optimal Asthma Control *
• Asthma: Assessment of Asthma Control - Ambulatory Care Setting
• Asthma Control: Minimal Important Difference Improvement*
• Asthma Assessment and Classification
• Lung Function/Spirometry Evaluation
• Patient Self-Management and Action Plan
Allergen Immunotherapy Measures
• Allergen Immunotherapy Treatment: Allergen Specific Immunoglobulin E (IgE) Sensitivity Assessed and Documented Prior to Treatment
• Documentation of Clinical Response to Allergen Immunotherapy within One Year
• Documented Rationale to Support Long-Term Aeroallergen Immunotherapy Beyond Five years, as Indicated
• Achievement of Projected Effective Dose of Standardized Allergens for Patient Treated With Allergen Immunotherapy for at Least One Year *
• Assessment of Asthma Symptoms Prior to Administration of Allergen Immunotherapy Injection(s)
• Documentation of the Consent Process for Subcutaneous Allergen Immunotherapy in the Medical Record
Drug Allergy Measure
• Penicillin Allergy: Appropriate Removal or Confirmation *
• Measure #331: Adult Sinusitis: Antibiotic Prescribed for Acute Sinusitis (Appropriate Use)
• Measure #332: Adult Sinusitis: Appropriate Choice of Antibiotic: Amoxicillin Prescribed for Patients with Acute Bacterial Sinusitis (Appropriate Use)
• Measure #333: Adult Sinusitis: Computerized Tomography (CT) for Acute Sinusitis (Overuse)
• Measure #334: Adult Sinusitis: More than One Computerized Tomography (CT) Scan Within 90 Days for Chronic Sinusitis (Overuse)
General Care Measures
• PQRS Measure #226 (NQF 0028, e-CQM CMS 138v4): Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
• PQRS Measure #402: Tobacco Use and Help with Quitting Among Adolescents
• PQRS Measure #111 (NQF 0043, e-CQM CMS 127v4): Pneumonia Vaccination Status for Older Adults
• PQRS Measure #130 (NQF 0419, e-CQM CMS 68v5): Documentation of Current Medications in the Medical Record
• PQRS Measure #128 (NQF 0421, e-CQM CMS 69v4): Body Mass Index
• PQRS Measure #110 (NQF 0041, e-CQM CMS 147v5): Influenza Immunization
*Indicates outcomes measure
Where can I download the measure specifications?
Full specifications of the measures can be downloaded here.
Are there any other ways to successfully report for PQRS?
Yes. There are multiple ways to report measures for PQRS which include:
• Individual Measures via Traditional Registry*
• Measures Group via Traditional Registry *
• Qualified Clinical Data Registry
• Direct EHR product that is CEHRT (Certified Electronic Health Record Technology)
• EHR Data Submission Vendor that is CEHRT
• Group Practice Reporting Option (GPRO) via GPRO Web Interface
• Group Practice Reporting Option (GPRO) via Registry and EHR
Learn about the different reporting options on our PQRS reporting page.
For additional question please call (414) 272-6071 or e-mail QCDR@aaaai.org