Are you ready for PQRS in 2015?

Wednesday, August 26, 2015

2015 is a very important year for eligible professionals (EP) to report to the Physician Quality Reporting System (PQRS). Although the incentives for reporting PQRS expired in 2014, EPs who successfully report PQRS in 2015 will avoid the PQRS negative payment adjustment of -2% on their Medicare FFS Part B claims in 2017.

Value Based Payment Modifier

In addition, successful reporting in 2015 will also ensure that the EP or group avoids the automatic negative payment adjustments under the Value Based Payment Modifier (VBPM) in 2017. VBPM adjustments vary depending on group size and range from -2% to -4%.

EPs that successfully report PQRS will be subject to VBPM’s Quality Tiering process where providers who perform lower than the national average will receive a negative payment adjustment of up to -4%. EPs that successfully report PQRS and score higher than the national average will be eligible for positive payment adjustments. All payment adjustments, positive or negative, will be applied to the EP’s Part B claims in 2017.

It is important to note that these payment adjustments are in addition to any negative payment adjustments from the Meaningful Use program, as these two programs are completely separate. Attesting for Meaningful Use will not satisfy PQRS program requirements!

Are you asking, "Does this affect me?"

Any provider that has Medicare FFS Part B claims during the reporting year is eligible for PQRS. Eligible providers include physicians, nurse practitioners, physician assistants, and many allied health professionals. For a complete list please refer to 2015 PQRS List of Eligible Professionals.

How can PHA help?

PQRS reporting is often challenging for both small and large groups due to the various methods and requirements to successfully report the measures. PHA understands these challenges, therefore, beginning on September 8th we are offering you a complementary call (up to 1 hour) to discuss your organization’s best path toward successful reporting. To schedule your call with our PQRS experts, please contact Brian McCammon at or 844-748-3678. He can also help connect you with other PHA consultation and direct assistance services, which include:

  • Measure Selection
  • Reporting Method Selection
  • Enterprise Identity Management System (EIDM) Registration
  • Quality Resource Use Report (QRUR) interpretation

Writer: Natalie Stewart, 765-496-1265,

Tags: Quality Services

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