2014 Physician Quality Reporting

Medicare's Physician Quality Reporting System was developed by the Centers for Medicare and Medicaid Services (CMS) to provide a financial incentive to physicians who volunteer to report on best-practice quality measures. 

2015 Physician Quality Reporting

In 2015, eligible professionals (EPs) must report at least nine quality measures that cover at least three of the National Quality Strategy Domains. An EP is any provider who bills Medicare under his or her own NPI. If an EP works under multiple tax ID numbers (TINs), he or she must report PQRS under each one.

CMS also detailed a new requirement stating that at least one of the reported measures must be from a set of cross-cutting measures.  Each measure must be reported for at least 50 percent of the EP’s Medicare Part B fee-for-service patients seen Jan. 1 through Dec. 31, 2015 for which the measure applies. The five dermatology-specific measures, #137, #138, #224, #265, and #337, from the 2014 program will continue. Additionally, there will be a new pathology measure that applies to melanoma: measure #397. This measure looks at whether the EP has documented pathology reports for primary malignant cutaneous melanoma that include the pT category and a statement on thickness and ulceration and for pT1, mitotic rate.

If less than nine measures apply, EPs must go through the Measure Applicability Validation (MAV) process. CMS uses this process to evaluate whether or not EPs could have reported on additional measures, and determine whether or not they satisfied reporting requirements.

If less than nine measures apply, EPs must go through the Measure Applicability Validation (MAV) process. CMS uses this process to evaluate whether or not EPs could have reported on additional measures, and determine whether or not they satisfied reporting requirements.

  • See registry MAV requirements here
  • View the CMS MAV Training Course here

The forthcoming 2015 QRS registry will be able to report 18 measures.

  • Download a list of these measures here
  • View the final specifications for these measures here

2014 Physician Quality Reporting

The 2014 PQRS reporting period is the last year to earn the 0.5 percent bonus payment of total Medicare Part B allowed charges. Participation in 2014 PQRS will also allow you to avoid a 2 percent payment reduction in 2016. 

The 2014 Medicare Physician Fee Schedule final rule includes one new dermatology-specific measure, related to psoriasis. CMS also raised the number of PQRS measures that providers must report on to earn an incentive from three to nine, but lowered the reporting threshold for the measures from 80 percent to 50 percent. The nine measures must also cover at least three quality domains. 

To solely avoid the 2016 payment reduction, you must now report on at least three measures that cover at least one quality domain. However, CMS lowered the reporting threshold to 50 percent for this option as well. 

To report on nine measures for PQRS, dermatologists may apply other measures — not specific to dermatology ― that are still applicable to their practices. The AAD has developed a list of other measures that dermatologists will be able to report on through the Academy’s 2014 QRS registry:

  • Measure #137 — Melanoma: Continuity of Care — Recall System
  • Measure #138 — Melanoma: Coordination of Care 
  • Measure #224 — Melanoma: Overutilization of Imaging Studies
  • Measure #265 — Biopsy Follow-Up
  • Measure #337 — Tuberculosis Prevention for Psoriasis and Psoriatic Arthritis Patients on a Biological Immune Response Modifier
  • Measure #130 — Documentation of Current Medications in the Medical Record
  • Measure #131 — Pain Assessment and Follow-Up
  • Measure #173 — Preventive Care and Screening: Unhealthy Alcohol Use — Screening
  • Measure #194 — Oncology: Cancer Stage Documented
  • Measure #205 — HIV/AIDS: Sexually Transmitted Disease Screening for Chlamydia and Gonorrhea
  • Measure #226 — Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
  • Measure #245 — Chronic Wound Care: Use of Wound Surface Culture Technique in Patients with Chronic Skin Ulcers (Overuse Measure)
  • Measure #246 — Chronic Wound Care: Use of Wet to Dry Dressings in Patients with Chronic Skin Ulcers (Overuse Measure)

The QRS registry will only allow users to choose a combination of nine measures that cover at least three quality domains. The quality domains are:

  1. Patient Safety
  2. Person and Caregiver-Centered Experience and Outcomes
  3. Communication and Care Coordination
  4. Effective Clinical Care
  5. Community/Population Health
  6. Efficiency and Cost Reduction

Download the final specifications for these measures here.

The 2014 QRS module will be $249 per provider. QRS must be purchased under the AAD ID and password of the physician or non-physician clinician who will be reporting.