The following are frequently asked questions about the Medicare Physician Quality Reporting System (PQRS). Reporting quality performance measures assists AAD members in improving patient safety and quality in their clinical practice settings. The best-practice measures are meant to encourage practices to align their clinical operations with the quality measures the AAD establishes and that are approved by both the National Quality Forum (NQF) and the Centers for Medicare and Medicaid Services (CMS).

Q: What is the Physician Quality Reporting System?

A: The Physician Quality Reporting System (PQRS), formerly known as PQRI, is a program developed by the Centers for Medicare and Medicaid Services (CMS) to provide a financial incentive bonus to physicians who volunteer to report on best-practice quality measures for the Medicare patients they treat.

Q: How much will my incentive payment be?

A: If a participant successfully meets all criteria of the PQRS program, he or she will receive a bonus of 0.5 percent of total allowed Medicare Part B charges to CMS for the calendar year.

Q: If I participated in PQRS and did not earn an incentive, can I appeal to CMS?

A: CMS allows participants to request an informal appeal via the QualityNet Help Desk so your PQRS data can be reviewed to determine if a mistake was made. You can contact the QualityNet Help Desk at (866) 288-8912 (TTY (877) 715-6222) or at http://qnetsupport@sdps.org. They are available Monday through Friday from 7 a.m. to 7 p.m. CT.

Q: The dermatologist I work for told me I need to submit his or her PQRS information through a registry. What does that mean?

A: A registry is an electronic system that is built by an outside company (vendor) that allows physician practices to enter quality information online. All vendors have to be registered on a qualified list with CMS to report PQRS data.

Q: I participated in this program in the past using my claims forms; am I able to do that this year?

A: If you choose to report the dermatology-appropriate measures #137, #138, #224, and/or #265, then you must report via registry. CMS determined that these measures can only be answered through an electronic registry in 2012. However, there are other measures that a dermatologist may be able to report via claims; a listing of those other measures can be found here.

Q: How many measures do I have to report?

A: Providers must report a minimum of three measures to earn the incentive. There is no advantage to reporting more than three.

Q: How many measures do I have to meet?

A: You do not have to meet every measure, however:

• You must have greater than a 0 percent performance rate for all reported measures.
• Not every reported patient needs to meet all three measures.
• Each of the quality measures must have at least one eligible instance.

Q: How will the health care reform law affect PQRS?

A: The Patient Protection and Affordable Care Act will continue to offer incentives for participation through 2014. However, an eligible professional will have to report for the 2013 reporting period to avoid the penalty in 2015.

Q: How have physicians performed in the past?

A: The CMS 2010 PQRS and eRx Experience Report indicated that there were more than 180,000 MD/DO participants in the 2010 PQRS program, with almost 129,000 MD/DO participants earning PQRS incentive payments. The report also compiled data by specialty, using the primary specialty designated by each MD/DO in the National Plan and Provider Enumeration System (NPPES).

2010 PQRS performance — All MD/DO participants and dermatology MD/DO participants

2009 PQRS performance — All MD/DO participants and dermatology MD/DO participants

2010 PQRS performance (all reporting methods) — Other specialties by comparison

2009 PQRS performance (all reporting methods) — Other specialties by comparison

Source: 2012 reporting experience, including trends (2007-2011): Physician Quality Reporting System and electronic prescribing (eRx) incentive program. Feb. 22, 2012.