The Physician’s Quality Reporting Initiative (PQRI) for Medicare Part B FFS patients
provides 2% bonuses in 2009 and 2010 on all Part B FFS revenues. An additional 2%
bonus can be earned by utilization of our eRX system.
Most importantly, Quality Reporting is one of the keys to the treasure chest of $50
billion dollars of IT entitlements provided by the ARRA/HiTech Act. Pursuant to
the Act, eligible providers can receive between $48,000 and $65,000 if they use
a certified EHR system in a “meaningful” way. Of special note, the provider can
retain the difference between what they receive and what they actually spend!
There are 153 individual PQRI quality measures however, 18 of the measures can only
be reported through a Registry. An eligible health care provider can choose to report
on individual measures or a Measure Group.
For each PQRI measure, the answer is, “Yes, I performed the measure,” or “No, I
did not,” for either a “medical reason” or an “unspecified reason.”
Eligible healthcare provider (HCP) should report on as many measure groups or
individual measures as are applicable to one’s medical practice. The
PQRI bonuses are based upon minimally reporting on 1 measure group or 3 individual
measures* The threshold for successful patient reporting is based on either reporting
on 30 consecutive patients** or on 80% of all Medicare Part B FFS patients.
*For certain medical specialties only 1 or 2 measures may apply, yet these specialists
can still earn the bonus. More than 30 medical associations have endorsed specific
PQRI quality measures or measure groups.
**Uniquely, if Registry reporting for a Measure Group is selected, then only
2 of the 30 consecutive patients must be Medicare Part B FFS.
Registry Reporting:
Registry reporting is a simple process; no PQRI information is submitted on the
1500 Claim Form. EHealth Made Easy LLC will submit all your Registry PQRI data to
Medicare after December 31, 2009.
A healthcare provider must choose whether to report on 30 consecutive Part B FFS
patients seen between July 1 and December 31, 2009 or on 80 percent of the Medicare
Part B FFS in the same time period. If a healthcare provider chooses to report
using a Registry Measure Group, the 2 percent bonus is retroactive to January 1,
2009.
Alternatively, an eligible healthcare provider can choose to report on 3 or more
individual measures but the 2 percent bonus payment period begins July 1, 2009.
The Developers of the Quality Measures Are:
*These Quality Measures have been endorsed by more than 30 Medical Associations
(click through)
• AMA-PCPI
American Medical Association-sponsored Physician Consortium on Performance Improvement
email questions and comments to the PCPI at cpe@ama-assn.org
• APMA
American Podiatric Medical Association email questions and comments at
http://www.apma.org/s_apma/secmember.asp?CID=421&DID=17174
• ASTRO
American Society for Therapeutic Radiology and Oncology
www.astro.org and click on “Contact Us”
• ASH
American Society of Hematology email questions and comments to
ash@hematology.org
• ASCO
American Society of Clinical Oncology www.asco.org
and click on “Contact Us”
• CAP
College of American Pathologists e-mail questions and comments at
www.cap.org
• CMS
Centers for Medicare & Medicaid Services email questions and comments to
PQRIFAQS@cms.hhs.gov
• CMS/QIP
Quality Insights of Pennsylvania email questions and comments at
PQRIFAQS@cms.hhs.gov
• NCCN
National Comprehensive Cancer Network
http://www.nccn.org/about/contact.asp
• NCQA
National Commission for Quality Assurance www.ncqa.org
and click on “Contact Us”
• STS
Society of Thoracic Surgeons email questions and comments to
sts@sts.org
• SVS
Society of Vascular Surgeons e-mail questions and comments at
www.vascularweb.org