2016 PQRS

The Physician Quality Reporting System (PQRS) Program is a CMS quality initiative that affects eligible providers' (EPs’) reimbursement rates for covered Physician Fee Schedule (PFS) services furnished to Medicare Part B Fee-For-Service (FFS) beneficiaries. Although technically a voluntary program, non-participation in the PQRS program has financial implications for future Medicare Part B FFS reimbursement. Financial implications are in the form of payment adjustments based on satisfactory reporting of PQRS measures. Compliance with PQRS reporting requirements also has repercussions beyond the PQRS program so understanding this program is essential to CRNAs' ability to safeguard their Medicare billings.  

The 2016 PQRS performance period started on January 1, 2016 and ended on December 31, 2016. The 2018 payment adjustments based on the 2016 performance period are finalized in the fall of 2017.

CMS Disclaimer: “Please note, although CMS has attempted to align or adopt similar reporting requirements across programs, EPs should look to the respective quality program to ensure they satisfy the PQRS, EHR Incentive Program, Value-Based Payment Modifier (VM), etc. requirements for each of these programs.”