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Medicare's Physician Quality Reporting Initiative (PQRI)

On December 20, 2006 the President signed the Tax Relief and Health Care Act of 2006 (TRHCA), which authorized the Centers for Medicare and Medicaid Services (CMS) to establish and implement a physician quality reporting system. In response to the mandate, CMS created the Physician Quality Reporting Initiative (PQRI).

According to CMS, "The PQRI provides a financial incentive for eligible professionals to participate in a voluntary quality reporting program. Eligible professionals who successfully report a designated set of quality measures on claims for dates of service from July 1 to December 31, 2007, may earn a bonus payment, subject to a cap, of 1.5% of total allowed charges for covered Medicare physician fee schedule services."

In July 2007, CMS proposed a 2008 PQRI. This proposal was finalized in November as part of the 2008 Medicare Physician Fee Schedule (MPFS) Final Rule.  The 2008 PQRI is similar to the 2007 PQRI, in that eligible professionals who successfully report a designated set of quality measures on claims for dates of service from January 1 to December 31, 2008, may earn a bonus payment. The bonus payment is expected to be around 1.5% for those who successfully report. 

As reported in our weekly e-newsletter, the Washington Watch Weekly, new measures have been added to the 2008 PQRI and others have been removed.  A complete list of the 2008 PQRI measures and measure specifications are listed below.

Please contact the ASCRS Government Relations department at 703-591-2220 should you have questions or require clarification on current and future quality initiatives.   

  • 2008 CMS PQRI: Data Collection Tool for Ophthalmology (01/28/2008)

  • 2008 CMS PQRI: Handbook for the 2008 PQRI (12/27/2007)

  • 2008 CMS PQRI: Materials for the ASCRS/ASOA PQRI Conference Call with CMS on December 20, 2007 (12/20/2007)

  • 2008 CMS PQRI: Measure Specifications (01/02/2008)

  • 2008 CMS PQRI: Release Notes (12/28/2007)

  • CMS PQRI Web site (06/06/2007)

  • CMS PQRI: Frequently Asked Questions (06/06/2007)

  • S1519 - The Voluntary Medicare Quality Reporting Act of 2007 (06/06/2007)
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