In 2016, eligible professionals (EPs) must report at least nine quality measures that cover at least three of the National Quality Strategy Domains, one of which must be a cross-cutting measure. 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.
Download measure specs for each of the 19 applicable measures.
The potential payment reduction for not reporting PQRS in 2016 could be up to 6 percent of Medicare charges, depending on the size of the practice (reduction to be applied in 2018). The penalties are broken down as such:
2 percent PQRS payment reduction plus an additional 2-4 percent value-based payment modifier (VBPM) reduction (group practices with 10 or more providers automatically receive a 4 percent VBPM reduction).
The table below shows the ways in which you may avoid payment penalties for the 2016 PQRS reporting year.