Physician Quality Reporting System

CODE Technology has self-nominated and been approved for the 2016 program year as a Qualified Clinical Data Registry (QCDR) for the Centers for Medicare & Medicaid Services’ (CMS) Physician Quality Reporting System (PQRS).

We are capable of submitting on behalf individual eligible provider (EP) and group practice reporting (GPRO) in order to meet Meaningful Use (MU) requirements. We support 19 PQRS measures and 5 non-PQRS measures that leverage your collected outcome data. Click here for more detail on the measures we support.

However, it’s important to note that PQRS is in transition under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). PQRS is being combined with MU, and the Value-Based Modifier (VBM) to create a new entity: the Merit-Based Incentive Payment System (MIPS), which encourages quality initiatives by enabling participants to earn up to a 5% performance-based payment adjustment following the performance year.

This year is a trial run for MIPS, with the first performance period beginning January 1, 2017 and runs through December 31, 2017. The data submission deadline is March 31, 2018, and the payment adjustment period will begin in January of 2019.

Through MIPS, data is reported in four categories: Quality (50%), Advancing Care Information (25%), Clinical Practice Improvement Activities (CPIA, 15%), and Resource Use/Cost (10%).

As part of the initiative, MIPS participants need to select six different measures in the Quality Performance category to report to CMS, in which some overlap with PQRS measures. Of these six measures, one must be an outcome measure and one must be considered high-priority, which can be an outcome, appropriate use, patient experience, patient safety, efficiency or care coordination measure.  Click here to see the 22 MIPS measures CODE has submitted to CMS in 2017.