Practice Tools Menu

2016 reporting details

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.

Payment reductions

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.

National Quality Strategy (NQS) domains 

Cross-cutting measures 

Report three out of six to avoid penalty  Report at least one measure to avoid penalty 
1. Patient Safety  
2. Patient and Family Engagement 
3. Care Coordination 
4. Clinical Processes and Effectiveness 
5. Population and Public Health 
6. Efficient Use of Healthcare Resources 
#130 
#131 
#226 
#46
#110 
#111 
#128 
#47 
  #317
  #431 

 

MAV exception

If you cannot reach the required nine measures, you may apply for the Measure Applicability Validation (MAV) exception. CMS uses this process to evaluate whether or not EPs could have reported on additional measures, and determines whether or not reporting requirements have been satisfied. Learn more about the MAV process.

 


 

This webinar helps AAD members navigate the 2016 PQRS process, outlines penalties, and offers information on reporting through AAD's DataDerm™. (14 minutes)

Download the webinar Powerpoint.


View video segments of the full powerpoint broken out by the following topics
:
  • Why report quality measures?
  • Who should participate in PQRS?
  • How many quality measures need to be reported in 2016?
  • What are dermatology specific measures in 2016?
  • How to report PQRS
  • What is the MAV process?
  • How to get started reporting PQRS
  • What are deadlines for reporting PQRS?

VIEW VIDEO LIBRARY